JACKSONVILLE AMBULATORY SURGERY CENTER, LLC – NPI #1497614986
Clinic/Center

JACKSONVILLE AMBULATORY SURGERY CENTER, LLC is an AHC clinic located in SAINT JOHNS, FL. NPPES has assigned the NPI number 1497614986 to JACKSONVILLE AMBULATORY SURGERY CENTER, LLC on January 20, 2026. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QA1903X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Ambulatory Surgical

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 JACKSONVILLE AMBULATORY SURGERY CENTER, LLC below.

NPI Profile for
JACKSONVILLE AMBULATORY SURGERY CENTER, LLC

NPI Number
1497614986
Enumeration Date

(about 5 months 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
JACKSONVILLE AMBULATORY SURGERY CENTER, LLC
Primary location
75 BARREN WAY
SAINT JOHNS, FL 32259
Phone: (904) 889-0061 Fax:
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
JAMIE THIBODEAUX
CHIEF ADMINISTRATIVE OFFICER
Phone: (904) 889-0061
Updated
Certification Date
Jan 13, 2026

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
261QA1903X
- Clinic/Center / Ambulatory Surgical (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.