PROVIDENCE PRIMARY CARE – NPI #1487302857
Clinic/Center

A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

Health Care Provider Taxonomy Code for Clinic/Center

PROVIDENCE PRIMARY CARE is an AHC clinic located in JACKSONVILLE, FL. NPPES has assigned the NPI number 1487302857 to PROVIDENCE PRIMARY CARE on March 15, 2022. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “PROVIDENCE PRIMARY CARE” is a dba name, the actual legal business name for this organization is BEST LEAF LLC. The primary taxonomy selected by this provider is 261Q00000X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center.

The NPI profile was previously updated about 4 years ago on Jul 26, 2022. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for PROVIDENCE PRIMARY CARE below.

NPI Profile for
BEST LEAF LLC

NPI Number
1487302857
Enumeration Date

(more than 4 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
BEST LEAF LLC
Doing Business As (dba): PROVIDENCE PRIMARY CARE
Primary location
9765 SAN JOSE BLVD STE 103
JACKSONVILLE, FL 32257-5467
Phone: (904) 476-0966 Fax:
Mailing address
PO BOX 2585
JACKSONVILLE, FL 32203-2585
Phone: (904) 476-0966 Fax:
Organization Subpart
No
Authorized Official
TAKAYA JONES
MANAGER/OWNER
Phone: (904) 476-0966
Updated
Certification Date
Jul 26, 2022

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261Q00000X
- Clinic/Center (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.