ST AUGUSTINE PRIMARY CARE P L
NPI 1760654370
Family Medicine in St Augustine, FL

Q: What is St Augustine Primary Care P L's NPI number?

The NPI number for St Augustine Primary Care P L is 1760654370. It was assigned to this organization in the NPPES registry on March 24, 2008.

Q: What is St Augustine Primary Care P L's specialty?

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

Active since March 24, 2008CLIA 10D2162058 · Waiver

811 STATE ROAD 206 E STE 3, ST AUGUSTINE, FL 32086(904) 342-2989(904) 824-6243 Get Directions Write a Review

NPPES record last updated: June 16, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Nov 5, 2024, Aug 5, 2020 (2 updates tracked since 2020).

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About St Augustine Primary Care P L NPPES

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

ST AUGUSTINE PRIMARY CARE P L (NPI 1760654370) is a healthcare organization registered as a family medicine in St Augustine, Florida and active in the NPI registry since March 2008. The organization holds a CLIA Waiver certificate valid through February 14, 2027, maintains a secondary practice location in St Augustine, and lists Brian David Raymaker, Owner, as its authorized official.

NPPES Registry Identity

NPI1760654370

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameST AUGUSTINE PRIMARY CARE P L

Location Address811 STATE ROAD 206 E STE 3St Augustine, FL 32086-4869

Mailing AddressPo Box 3123St Augustine, FL 32085-3123 · (904) 342-2989 · Fax (904) 826-6243

Phone(904) 342-2989

Fax(904) 824-6243

Organization SubpartNo

Authorized OfficialBrian David RaymakerOwner · (904) 342-2989

Enumeration DateMarch 24, 2008

Last NPPES UpdateJune 16, 20262 updates tracked since enumeration

NPPES CertifiedJune 16, 2026

✔ NPI 1760654370 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in FL · 40261

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.

811 STATE ROAD 206 E STE 3, St Augustine, FL 32086

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Secondary Practice Location 1

Location 1105 Mariner Health Way Ste 203St Augustine, FL 32086-3251 · Phone (904) 342-2989 · Fax (904) 824-6243

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 10D2162058

St Augustine Primary Care Pl · St Augustine, FL

Active · expires Feb 14, 2027

CLIA Number10D2162058

Laboratory TypePhysician Office

Certificate Effective DateFebruary 15, 2025

Certificate Expiration DateFebruary 14, 2027

Laboratory DirectorJudith L. Nichols

Laboratory Phone(904) 342-2989

Laboratory LocationSt Augustine Primary Care Pl811 Sr 206 E Unit #3, St Augustine, FL 32086

CLIA data matches this NPI record on: 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.

JENNIFER LYNN LOPEZ APRN

Nurse Practitioner

811 STATE ROAD 206 E STE 3
ST AUGUSTINE, FL 32086

St. Johns County (904) 342-2989

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 St Augustine Primary Care P L's NPI number?

The NPI number for St Augustine Primary Care P L is 1760654370. It was assigned to this organization in the NPPES registry on March 24, 2008.

Where is St Augustine Primary Care P L located?

St Augustine Primary Care P L is located at 811 State Road 206 E Ste 3, St Augustine, FL 32086. The listed phone number is (904) 342-2989.

What is St Augustine Primary Care P L's specialty?

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

Does St Augustine Primary Care P L hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2162058) is associated with this NPI, valid through February 14, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for St Augustine Primary Care P L was last updated on June 16, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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.