Individual provider Active NPI

Brandon Neil Hillard, APRN

  • Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1003466830
Registry record updated Apr 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11010517 Issued in FL
Practice address
4401 Emerson St Ste 8
Jacksonville, FL 32207-4954
Phone
(904) 387-9406
Fax
(904) 212-0381
NPI assigned
Sep 13, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN9423141 FL
Home Health Registered Nurse 163WH0200X RN9423141 FL
Nurse Practitioner 363L00000X APRN11010517 FL Primary

Addresses

Primary practice location

4401 Emerson St Ste 8
Jacksonville, FL 32207-4954

Mailing address

4656 Tunis Street
Jacksonville, FL 32205
Phone (904) 662-4853

Other identifiers 1

IdentifierTypeStateIssuer
100682400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN9423141FLMDHome Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Nursing on Demand Primary Care, Inc CurrentSince May 28, 2023 Accepting new patients
American Advanced Practice Network, P.C. Nurse Practitioner CurrentSince Jun 1, 2021 Accepting new patients
Nursing on Demand, Inc. CurrentSince Apr 9, 2023 Accepting new patients
Concierge Home Services, Inc PastSince Sep 15, 2019 Accepting new patients

Locations

1260 McDuff Ave S
Ste 4
Jacksonville, FL 32205

1260 McDuff Ave S
#4
Jacksonville, FL 32205
Phone (904) 387-9406

1260 McDuff Ave S
Jacksonville, FL 32205
Phone (904) 387-9406

4401 Emerson St
Ste 8
Jacksonville, FL 32207
Phone (904) 344-0517

5300 San Juan Ave
Jacksonville, FL 32210
Phone (904) 388-2676

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1568332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680480000000",
    "number": "1003466830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4656 TUNIS STREET",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32205",
            "telephone_number": "904-662-4853",
            "fax_number": "604-212-0381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 EMERSON ST STE 8",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322074954",
            "telephone_number": "904-387-9406",
            "fax_number": "904-212-0381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILLARD",
        "first_name": "BRANDON",
        "middle_name": "NEIL",
        "name_prefix": "Mr.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-13",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9423141",
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "FL",
            "license": "RN9423141",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11010517",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100682400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.