ST AUGUSTINE PRIMARY CARE P L
NPI 1760654370
Family Medicine in St Augustine, FL

NPI Status: Active since March 24, 2008

Contact Information

811 STATE ROAD 206 E STE 3
ST AUGUSTINE, FL
ZIP 32086
Phone: (904) 342-2989
Fax: (904) 824-6243

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  • Organization
  • Family Medicine
  • CLIA Number: 10D2162058
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 02-14-2027

About ST AUGUSTINE PRIMARY CARE P L

This page provides the complete NPI Profile along with additional information for St Augustine Primary Care P L, a primary care provider established in St Augustine, Florida operating as a Family Medicine. The healthcare provider is registered in the NPI registry with number 1760654370 assigned on March 2008. The practitioner's primary taxonomy code is 207Q00000X with license number 40261 (FL). The provider is registered as an organization and their NPI record was last updated one year ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Brian David Raymaker M.d. (Owner)

NPI
1760654370
Provider Name
ST AUGUSTINE PRIMARY CARE P L
Entity Type
Organization
Location Address
811 STATE ROAD 206 E STE 3 ST AUGUSTINE, FL 32086
Location Phone
(904) 342-2989
Location Fax
(904) 824-6243
Mailing Address
PO BOX 3123 ST AUGUSTINE, FL 32085
Mailing Phone
(904) 342-2989
Mailing Fax
(904) 824-6243
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
03-24-2008
Last Update Date
11-05-2024
Code Navigator

A primary care provider (PCP) like St Augustine Primary Care P L sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Secondary Locations

  • 105 Mariner Health Way Ste 203
    St Augustine, FL 32086
    (904) 342-2989

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

Family Medicine

Taxonomy Code
207Q00000X
Type
Allopathic & Osteopathic Physicians
License No.
40261
License State
FL
Taxonomy Description
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

BRIAN DAVID RAYMAKER M.D.

Authorized Official Title
OWNER
Authorized Official Phone
(904) 342-2989

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
10D2162058
Facility Type
Physician Office
Certificate Effective Date
February 15, 2025
Certificate Expiration Date
February 14, 2027
Laboratory Director
JUDITH L. NICHOLS
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to St Augustine Primary Care P L 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.
1760654370
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
271201258314
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 1 + 2 + 0 + 1 + 2 + 5 + 8 + 3 + 1 + 4 + 24 = 60
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1760654370 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1750103362 JENNIFER LYNN LOPEZ APRN
Individual
Nurse Practitioner811 STATE ROAD 206 E STE 3
ST AUGUSTINE, FL 32086
(904) 342-2989

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1760654370, enumerated in the NPI registry as an "organization" on March 24, 2008

The provider is located at 811 State Road 206 E Ste 3 St Augustine, Fl 32086 and the phone number is (904) 342-2989

This medical organization specializes in Family Medicine with taxonomy code 207Q00000X

The provider's CLIA number is 10D2162058 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 March 24, 2008. 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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