ST VINCENT'S FULL SERVICE URGENT CARE, LLC
NPI 1750672051
Clinic/Center - Occupational Medicine in Jacksonville, FL
NPI Status: Active since April 21, 2011
Contact Information
10503 SAN JOSE BLVD
JACKSONVILLE, FL
ZIP 32257
Phone: (904) 379-1203
Fax: (904) 379-9282
- Organization
- Clinic/Center
- Occupational Medicine
- Accepts Insurance
- CLIA Number: 10D2125454
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 02-06-2027
About ST VINCENT'S FULL SERVICE URGENT CARE, LLC
This page provides the complete NPI Profile along with additional information for St Vincent's Full Service Urgent Care, Llc, a provider established in Jacksonville, Florida operating as a Clinic/center, focusing in occupational medicine . The healthcare provider is registered in the NPI registry with number 1750672051 assigned on April 2011. The practitioner's primary taxonomy code is 261QX0100X. The provider is registered as an organization and their NPI record was last updated 7 years ago. The authorized official of this NPI record is Andrea Mendoza (Chief Rev. Cycle Specialist)
- NPI
- 1750672051
- Provider Name
- ST VINCENT'S FULL SERVICE URGENT CARE, LLC
- Entity Type
- Organization
- Location Address
- 10503 SAN JOSE BLVD JACKSONVILLE, FL 32257
- Location Phone
- (904) 379-1203
- Location Fax
- (904) 379-9282
- Mailing Address
- 4205 BELFORT RD STE 4015 JACKSONVILLE, FL 32216
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 04-21-2011
- Last Update Date
- 07-23-2018
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Occupational Medicine
- Taxonomy Code
- 261QX0100X
- Type
- Ambulatory Health Care Facilities
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center | |
| 2 | 261QU0200X | Ambulatory Health Care Facilities | Clinic/Center |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
- Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
- Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
- Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
- Gold 3 Advanced: Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
- Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
- Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Silver 5 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
- Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
- Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 + Adult Dental+Vision - HMO
- AvMed Entrust Bronze 600 (2025) - HMO
- AvMed Entrust Bronze 650 (2025) - HMO
- AvMed Entrust Expanded Bronze Standard (2025) - HMO
- AvMed Entrust Gold 125 (2025) - HMO
- AvMed Entrust Gold 125 Dental+Vision (2025) - HMO
- AvMed Entrust Gold Standard (2025) - HMO
- AvMed Entrust Platinum 25 (2025) - HMO
- AvMed Entrust Platinum 25 Dental+Vision (2025) - HMO
- AvMed Entrust Platinum Standard (2025) - HMO
- AvMed Entrust Silver 350 (2025) - HMO
- AvMed Entrust Silver 350 Dental+Vision (2025) - HMO
- AvMed Entrust Silver 550 (2025) - HMO
- AvMed Entrust Silver 550 Dental+Vision (2025) - HMO
- AvMed Entrust Silver Standard (2025) - HMO
- BlueOptions Bronze (HSA) 24J01-10 (Rewards / $4 Condition Care Rx) - PPO
- BlueOptions Bronze 24J01-04 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $55 / Rewards) - PPO
- BlueOptions Bronze 24J01-06 ($0 Virtual PCP Visits / Rewards) - PPO
- BlueOptions Bronze 24J01-17 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - PPO
- BlueOptions Bronze 24J01-18S (Multilingual Available / Rewards) - PPO
- BlueOptions Gold 24J01-09 ($0 Virtual PCP Visits / $15 PCP Visits / Rewards) - PPO
- BlueOptions Gold 24J01-12 ($0 Virtual PCP Visits / $15 Labs / Rewards) - PPO
- BlueOptions Gold 24J01-20S ($30 PCP Visits / Multilingual Available / Rewards) - PPO
- BlueOptions Platinum 24J01-05 ($0 Virtual PCP Visits / $0 Labs / $15 PCP Visits / Rewards) - PPO
- BlueOptions Platinum 24J01-08 ($0 Virtual PCP Visits / $0 Labs / $10 PCP Visits / Rewards) - PPO
- BlueOptions Platinum 24J01-21S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Multilingual Available / Rewards) - PPO
- BlueOptions Silver 24J01-03 ($0 Virtual PCP Visits / $0 Labs / Rewards) - PPO
- BlueOptions Silver 24J01-07 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - PPO
- BlueOptions Silver 24J01-19S ($40 PCP Visits / Multilingual Available / Rewards) - PPO
- BlueSelect Bronze (HSA) 1735 (Rewards / $4 Condition Care Rx) - EPO
- BlueSelect Bronze 1449 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $55 / Rewards) - EPO
- BlueSelect Bronze 2139 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - EPO
- BlueSelect Bronze 2139E ($0 Virtual PCP Visits / $50 PCP Visits / Adult Dental & Vision / Rewards) - EPO
- BlueSelect Bronze 2139V ($0 Virtual PCP Visits / $50 PCP Visits / Adult Vision / Rewards) - EPO
- BlueSelect Bronze 2342S ($50 PCP Visits / Multilingual Available / Rewards) - EPO
- BlueCare Bronze (HSA) 24K01-09 (Rewards / $4 Condition Care Rx) - POS
- BlueCare Bronze 24K01-03 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $55 / Rewards) - POS
- BlueCare Bronze 24K01-05 ($0 Virtual PCP Visits / Rewards) - POS
- BlueCare Bronze 24K01-25 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - POS
- BlueCare Bronze 24K01-31S (Multilingual Available / Rewards) - POS
- BlueCare Bronze 24K02-17 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $55 / Rewards) - POS
- BlueCare Bronze 24K02-18 ($0 Virtual PCP Visits / Rewards) - POS
- BlueCare Bronze 24K02-23 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - POS
- BlueCare Bronze 24K02-26S (Multilingual Available / Rewards) - POS
- BlueCare Gold 24K01-08 ($0 Virtual PCP Visits / $15 PCP Visits / Rewards) - POS
- BlueCare Gold 24K01-10 ($0 Virtual PCP Visits / $15 Labs / Rewards) - POS
- BlueCare Gold 24K01-33S ($30 PCP Visits / Multilingual Available/ Rewards) - POS
- BlueCare Gold 24K02-20 ($0 Virtual PCP Visits / $15 PCP Visits / Rewards) - POS
- BlueCare Gold 24K02-28S ($30 PCP Visits / Multilingual Available / Rewards) - POS
- BlueCare Platinum 24K01-04 ($0 Virtual PCP Visits / $0 Labs / $15 PCP Visits / Rewards) - POS
- BlueCare Platinum 24K01-07 ($0 Virtual PCP Visits / $0 Labs / $10 PCP Visits / Rewards) - POS
- BlueCare Platinum 24K01-34S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Multilingual Available / Rewards) - POS
- BlueCare Platinum 24K02-15 ($0 Virtual PCP Visits / $0 Labs / $10 PCP Visits / Rewards) - POS
- BlueCare Platinum 24K02-29S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Multilingual Available / Rewards) - POS
- BlueCare Silver 24K01-02 ($0 Virtual PCP Visits / $0 Labs / Rewards) - POS
- Bronze 4 - HMO
- Bronze 8 - HMO
- Gold 1 - HMO
- Gold 1 with Adult Vision Services - HMO
- Gold 8 - HMO
- Silver 1 - HMO
- Silver 1 with Adult Vision Services - HMO
- Silver 12 with First 4 Primary Care Visits Free - HMO
- Silver 8 - HMO
- Silver 9 - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 10D2125454
- Facility Type
- Physician Office
- Certificate Effective Date
- February 07, 2025
- Certificate Expiration Date
- February 06, 2027
- Laboratory Director
- BETTY PANAMPALLY
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to St Vincent's Full Service Urgent Care, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 7 | 5 | 0 | 6 | 7 | 2 | 0 | 5 | 1 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 7 | 10 | 0 | 12 | 7 | 4 | 0 | 10 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 7 + 1 + 0 + 0 + 1 + 2 + 7 + 4 + 0 + 1 + 0 + 24 = 49 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 50 - 49 = 1 | 1 | ||||||||
The NPI number 1750672051 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 8 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1881975365 | SATANJEEB SHAH RPH Individual | Pharmacist | 10503 SAN JOSE BLVD JACKSONVILLE, FL 32257 (904) 880-3938 |
| 1982017471 | AFFORDABLE DENTURES-JACKSONVILLE, P.A. Organization | Dentist | 10503 SAN JOSE BLVD SUITE 10 JACKSONVILLE, FL 32257 (904) 262-3695 |
| 1235187857 | DR. MICHAEL CORDOVA M.D. Individual | Family Medicine | 10503 SAN JOSE BLVD JACKSONVILLE, FL 32257 (904) 450-6700 |
| 1215283536 | ELIZABETH CAMPBELL Individual | Social Worker (Clinical) | 10503 SAN JOSE BLVD JACKSONVILLE, FL 32257 (904) 450-6700 |
| 1053769463 | DR. HEATHER TRAMEL SHARP MD Individual | Family Medicine | 10503 SAN JOSE BLVD JACKSONVILLE, FL 32257 (904) 450-6700 |
| 1508995036 | AFFORDABLE DENTURES -JACKSONVILLE, P.C. Organization | Dentist | 10503 SAN JOSE BLVD SUITE 10 JACKSONVILLE, FL 32257 (904) 262-3695 |
| 1467693358 | MR. WILLIAM GONZALEZ ARNP Individual | Nurse Practitioner (Family) | 10503 SAN JOSE BLVD JACKSONVILLE, FL 32257 (904) 450-6700 |
| 1740853845 | DRS. MCCLOW, CLARK & BERK PA Organization | Radiology (Diagnostic Radiology) | 10503 SAN JOSE BLVD JACKSONVILLE, FL 32257 (904) 450-6680 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1750672051, enumerated in the NPI registry as an "organization" on April 21, 2011
The provider is located at 10503 San Jose Blvd Jacksonville, Fl 32257 and the phone number is (904) 379-1203
This medical organization specializes in Clinic/Center with taxonomy code 261QX0100X with a focus in Occupational Medicine
The provider might be accepting Accepts: Aetna CVS Health, AvMed, Florida Blue (BlueCross. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 10D2125454 for a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on April 21, 2011. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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