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JAX FAMILY HEALTH CLINIC PLLC
NPI 1326914045
Family Medicine in St Augustine, FL

Active since October 13, 2025CLIA 10D2344220 · Waiver
130 LAND GRANT ST STE 6, ST AUGUSTINE, FL 32092(904) 999-4684 Get Directions Write a Review

NPPES record last updated: June 29, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jax Family Health Clinic Pllc NPPES

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

JAX FAMILY HEALTH CLINIC PLLC (NPI 1326914045) is a healthcare organization registered as a family medicine in St Augustine, Florida and active in the NPI registry since October 2025. The organization holds a CLIA Waiver certificate valid through May 18, 2028 and lists Subhadra Chereddy, Ceo, as its authorized official.

NPPES Registry Identity

NPI1326914045
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameJAX FAMILY HEALTH CLINIC PLLC
Location Address130 LAND GRANT ST STE 6St Augustine, FL 32092-2262
Mailing Address130 Land Grant St Ste 6St Augustine, FL 32092-2262 · (904) 999-4684
Phone(904) 999-4684
Organization SubpartNo
Authorized OfficialSubhadra ChereddyCeo · (904) 999-4684
Enumeration DateOctober 13, 2025
Last NPPES UpdateJune 29, 2026
NPPES CertifiedJune 29, 2026
✔ NPI 1326914045 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
130 LAND GRANT ST STE 6, St Augustine, FL 32092
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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 SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2344220

Jax Family Health Clinic PLLC · Saint Augustine, FL
Active · expires May 18, 2028
CLIA Number10D2344220
Laboratory TypePhysician Office
Certificate Effective DateMay 19, 2026
Certificate Expiration DateMay 18, 2028
Laboratory DirectorSubhadra Chereddy
Laboratory Phone(904) 999-4684
Laboratory LocationJax Family Health Clinic PLLC130 Land Grant St Suite 6, Saint Augustine, FL 32092
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

DR. SUBHADRA CHEREDDY MBBS
Family Medicine
130 LAND GRANT ST STE 6
SAINT AUGUSTINE, FL 32092
St. Johns County (904) 999-4684

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 Jax Family Health Clinic PLLC's NPI number?

The NPI number for Jax Family Health Clinic PLLC is 1326914045. It was assigned to this organization in the NPPES registry on October 13, 2025.

Where is Jax Family Health Clinic PLLC located?

Jax Family Health Clinic PLLC is located at 130 Land Grant St Ste 6, St Augustine, FL 32092. The listed phone number is (904) 999-4684.

What is Jax Family Health Clinic PLLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Jax Family Health Clinic PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2344220) is associated with this NPI, valid through May 18, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Jax Family Health Clinic PLLC was last updated on June 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 37 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.