Ascension St. Vincent's Southside – General Acute Care Hospital, NPI 1396926747

Ascension St. Vincent's Southside is a healthcare provider. based in Jacksonville, Florida. specializing in General Acute Care Hospital. The NPI Number for Ascension St. Vincent's Southside is 1396926747

Main info

Organization
Name
Ascension St. Vincent's Southside
NPI
1396926747
Phone
(904) 450-6020
Address
4205 BELFORT RD
Authorized Official
JEREMY DEAN KRAFT DIRECTOR- NET REVENUE
Enumeration Date
14 November 2007
Last Update Date
28 April 2022
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience51
Completeness80
Years active:18State licenses:0Digital endpointsUpdated within 12 months

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Provider Addresses for Ascension St. Vincent's Southside

  • 4205, Belfort Road, Jacksonville, Duval County, Florida, 32216, United States

    JAB # 4020

    JACKSONVILLE, FL 32216

    Phone: (904) 450-6020

    Type: Mailing

  • Saint Vincent’s Medical Center Southside, 4201, Belfort Road, Jacksonville, Duval County, Florida, 32216, United States

    JACKSONVILLE, FL 322161431

    Phone: (904) 296-3700

    Type: Location

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.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

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

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2008-01-10

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2023-12-31 (889 days ago).

Enrollment records

1

Earliest due date

2023-12-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20080110000704OHospitalFL2023-12-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

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 32216)

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Reviews

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Frequently asked questions

How is Ascension St. Vincent's Southside identified in CMS data?
CMS-hosted NPPES data lists Ascension St. Vincent's Southside with NPI 1396926747.
Can I rely on Ascension St. Vincent's Southside being an active provider?
As of the registry snapshot, Ascension St. Vincent's Southside is marked active.
What healthcare role does Ascension St. Vincent's Southside hold?
Scheduling teams often label Ascension St. Vincent's Southside under General Acute Care Hospital. Clinical services aligned with this taxonomy classification.
What address line appears for Ascension St. Vincent's Southside?
Ascension St. Vincent's Southside's geographic hint is Jacksonville, Florida in our summary view.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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