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MAINLAND PHYSICIANS GROUP LLC
NPI 1003419763
Family Medicine - Geriatric Medicine in St Augustine, FL

Active since November 17, 2020
100 ARRICOLA AVE, ST AUGUSTINE, FL 32080(904) 825-4368(904) 825-9107 Get Directions Write a Review

NPPES record last updated: November 17, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mainland Physicians Group Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MAINLAND PHYSICIANS GROUP LLC (NPI 1003419763) is a healthcare organization registered as a geriatric medicine in St Augustine, Florida and active in the NPI registry since November 2020. The organization lists John Paul James Shaddock, Director Of Network Managment, as its authorized official.

NPPES Registry Identity

NPI1003419763
Entity TypeOrganization
Primary Taxonomy207QG0300X
Legal Business NameMAINLAND PHYSICIANS GROUP LLC
Location Address100 ARRICOLA AVESt Augustine, FL 32080-4515
Mailing Address100 Arricola AveSt Augustine, FL 32080-4515 · (904) 825-4368 · Fax (904) 825-9107
Phone(904) 825-4368
Fax(904) 825-9107
Organization SubpartNo
Authorized OfficialJohn Paul James ShaddockDirector Of Network Managment · (850) 341-6322
Enumeration DateNovember 17, 2020
NPPES CertifiedNovember 17, 2020
✔ NPI 1003419763 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Geriatric MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QG0300X
Definition

A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital.

100 ARRICOLA AVE, St Augustine, FL 32080
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WILLIAM D BERMEO PAC
Family Medicine
100 ARRICOLA AVE
ST AUGUSTINE, FL 32080
St. Johns County (904) 825-4368
ODELAISYS ENRIQUEZ MD
Internal Medicine
100 ARRICOLA AVE
ST AUGUSTINE, FL 32080
St. Johns County (904) 825-4368
V.I.P MD CARE LLC
Internal Medicine
100 ARRICOLA AVE
ST AUGUSTINE, FL 32080
St. Johns County (954) 586-8058
MR. EUGENE KINNALY P.A.
Physician Assistant (Medical)
100 ARRICOLA AVE
ST AUGUSTINE, FL 32080
St. Johns County (904) 825-4701
ISLAND DOCTORS INTRASTATE LLC
Clinic/Center (Primary Care)
100 ARRICOLA AVE
SAINT AUGUSTINE, FL 32080
St. Johns County (904) 825-4368
ECHO MANAGED CARE, LLC
Clinic/Center (Primary Care)
100 ARRICOLA AVE
SAINT AUGUSTINE, FL 32080
St. Johns County (904) 825-4368
SARA MARIE OCAMPO DENSLOW APRN
Nurse Practitioner (Family)
100 ARRICOLA AVE
SAINT AUGUSTINE, FL 32080
St. Johns County (904) 825-4368
LEE WILLIAM ELGIN III MSN, CRNP, AGACNP-BC
Nurse Practitioner (Family)
100 ARRICOLA AVE
ST AUGUSTINE, FL 32080
St. Johns County (904) 825-4568

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mainland Physicians Group LLC's NPI number?

The NPI number for Mainland Physicians Group LLC is 1003419763. It was assigned to this organization in the NPPES registry on November 17, 2020.

Where is Mainland Physicians Group LLC located?

Mainland Physicians Group LLC is located at 100 Arricola Ave, St Augustine, FL 32080. The listed phone number is (904) 825-4368.

What is Mainland Physicians Group LLC's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Geriatric Medicine, with taxonomy code 207QG0300X.

When was this NPI record last updated?

The NPPES record for Mainland Physicians Group LLC was last updated on November 17, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.