Mainland Physicians Group LLC
Mainland Physicians Group LLC is a healthcare organization registered as Geriatric Medicine (Family Medicine) Physician in St Augustine, FL, holding Type 2 (organization) NPI 1003419763 since 2020. The authorized official on file is John Paul Shaddock, Director of Network Managment.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1003419763 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Mainland Physicians Group LLC |
| Practice address | 100 ARRICOLA AVE, St Augustine, FL, 32080 |
| Phone | 9048254368 |
| Fax | 9048259107 |
| Enumeration date | 2020-11-17 |
| Last updated in NPPES | 2020-11-17 |
Authorized official
| Name | John Paul Shaddock |
|---|---|
| Title | Director of Network Managment |
| Phone | 8503416322 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 207QG0300X | Geriatric Medicine (Family Medicine) Physician | Primary | — | — |
Copy-ready billing details
Provider: Mainland Physicians Group LLC NPI: 1003419763 Taxonomy: 207QG0300X (Geriatric Medicine (Family Medicine) Physician) Address: 100 ARRICOLA AVE, St Augustine, FL, 32080
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1457323834 | Eugene Kinnaly | Individual | Medical Physician Assistant | St Augustine, FL |
| 1760595821 | Roy Hinman | Individual | Family Medicine Physician | St Augustine, FL |
| 1154423267 | William Bermeo | Individual | Family Medicine Physician | St Augustine, FL |
| 1942535042 | Anna IV | Individual | Physician Assistant | St Augustine, FL |
| 1225456155 | V.I.P MD Care LLC | Organization | Internal Medicine Physician | St Augustine, FL |
| 1740796770 | Lee Elgin | Individual | Family Nurse Practitioner | St Augustine, FL |
| 1164916615 | Odelaisys Enriquez | Individual | Internal Medicine Physician | St Augustine, FL |
| 1669092110 | Sara Denslow | Individual | Family Nurse Practitioner | Saint Augustine, FL |
Verify this record
Cross-check NPI 1003419763 against the authoritative CMS record: view Mainland Physicians Group LLC on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What type of organization is Mainland Physicians Group LLC?
What is a Type 2 NPI?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2020-11-17.