ANCIENT CITY PEDIATRICS – NPI #1053598292
Pediatrics

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Health Care Provider Taxonomy Code for Pediatrics

ANCIENT CITY PEDIATRICS is a provider located in SAINT AUGUSTINE, FL. NPPES has assigned the NPI number 1053598292 to ANCIENT CITY PEDIATRICS on January 30, 2008. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 208000000X from the Health Care Provider Taxonomy code set, which is classified as Pediatrics.

The NPI profile was last updated on Sep 02, 2025. 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 ANCIENT CITY PEDIATRICS below.

NPI Profile for
ANCIENT CITY PEDIATRICS

NPI Number
1053598292
Enumeration Date

(more than 18 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
ANCIENT CITY PEDIATRICS
Primary location
1301 PLANTATION ISLAND DR S STE 104
SAINT AUGUSTINE, FL 32080-3108
Phone: (904) 461-1560 Fax: (904) 461-4304
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
ADRIENNE MCCOY
OFFICE MANAGER
Phone: (904) 461-1560
Updated
Certification Date
Oct 23, 2024

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
208000000X
- Pediatrics (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.