PONTE VEDRA PSYCHIATRY LLC – Child & Adolescent Psychiatry Physician, NPI 1366158883

PONTE VEDRA PSYCHIATRY LLC is a healthcare provider. based in Ponte vedra beach, Florida. specializing in Child & Adolescent Psychiatry Physician. The NPI Number for PONTE VEDRA PSYCHIATRY LLC is 1366158883

Main info

Organization
Name
PONTE VEDRA PSYCHIATRY LLC
NPI
1366158883
Phone
(904) 280-6701
Address
230 CANAL BLVD STE 2
Authorized Official
DR. JUSTIN SPOONER PRESIDENT MD
Enumeration Date
27 January 2023
Last Update Date
27 January 2023
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:3State licenses:0Digital endpointsOther names

Provider Addresses for PONTE VEDRA PSYCHIATRY LLC

  • 230 CANAL BLVD STE 2

    PONTE VEDRA BEACH, FL 320823745

    Phone: (904) 280-6701

    Fax: (904) 280-6702

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

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Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32082)

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Reviews

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Frequently asked questions

How do I look up PONTE VEDRA PSYCHIATRY LLC by NPI?
Use NPI 1366158883 when you need to reference PONTE VEDRA PSYCHIATRY LLC in forms, claims, or directories.
Is PONTE VEDRA PSYCHIATRY LLC currently active in the NPI registry?
CMS-published data lists PONTE VEDRA PSYCHIATRY LLC as an active registrant.
What kind of provider is PONTE VEDRA PSYCHIATRY LLC?
The page reflects Child & Adolescent Psychiatry Physician for PONTE VEDRA PSYCHIATRY LLC. Clinical services aligned with this taxonomy classification.
Where is PONTE VEDRA PSYCHIATRY LLC's primary listing?
We display Ponte Vedra Beach, Florida because that is what the record indicates for PONTE VEDRA PSYCHIATRY LLC.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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