Providence Primary Care in Jacksonville, FL

Providence Primary Care is a medicare enrolled primary clinic (Clinic/center) in Jacksonville, Florida. The current practice location for Providence Primary Care is 9765 San Jose Blvd Ste 103, Jacksonville, Florida. For appointments, you can reach them via phone at (904) 476-0966. The mailing address for Providence Primary Care is Po Box 2585, Jacksonville, Florida and phone number is (904) 476-0966.

Providence Primary Care is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1487302857. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (904) 476-0966.

Contact Information

	Providence Primary Care
	9765 San Jose Blvd Ste 103 Jacksonville FL 32257-5467
	(904) 476-0966
	Not Available

Map and Direction

Primary Care Clinic Profile

Full Name	Providence Primary Care
Speciality	Clinic/Center
Location	9765 San Jose Blvd Ste 103, Jacksonville, Florida
Authorized Official Name and Position	Takaya Linne Jones (MANAGER/OWNER)
Authorized Official Contact	9044760966
Accepts Medicare Insurance	Yes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Providence Primary Care Po Box 2585 Jacksonville FL 32203-2585 Ph: (904) 476-0966	Providence Primary Care 9765 San Jose Blvd Ste 103 Jacksonville FL 32257-5467 Ph: (904) 476-0966

NPI Details:

NPI Number	1487302857
Provider Enumeration Date	03/15/2022
Last Update Date	07/26/2022

Medicare PECOS Information:

Medicare PECOS PAC ID	8426444951
Medicare Enrollment ID	O20220408000470

Medical Identifiers

Medical identifiers for Providence Primary Care such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1487302857	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
261Q00000X	Clinic/center	(* (Not Available))	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Providence Primary Care acts as a billing entity for following providers:

Provider Name	Takaya L Jones
Provider Type	Practitioner - Family Practice
Provider Identifiers	NPI Number: 1801025424 PECOS PAC ID: 2860649480 Enrollment ID: I20120904000178

Reviews and Comments

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Providence Primary Care - Medicare Primary Care in Jacksonville, FL