Individual provider Active NPI

Colette C Ikem, MSN, CNM

  • Advanced Practice Midwife
  • Jacksonville, FL
National Provider Identifier
1013294610
Registry record updated Jun 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
11029274 Issued in FL
Practice address
515 W 6TH St
Jacksonville, FL 32206-4324
Phone
(904) 253-2720
NPI assigned
Nov 9, 2011
Last updated
Jun 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Women's Health Care Registered Nurse 163WW0101X RN9654688 FL
Advanced Practice Midwife 367A00000X 11029274 FL Primary

Addresses

Primary practice location

515 W 6TH St
Jacksonville, FL 32206-4324

Mailing address

515 W 6TH St
Jacksonville, FL 32206-4324
Phone (904) 253-2720

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240606004258 FL Practitioner - Nurse Practitioner 7618103508 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

653 W 8TH St
Jacksonville, FL 32209-6511
Phone (904) 244-7874

655 W 8TH St
Jacksonville, FL 32209-6511
Phone (904) 244-7874

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN9654688FLMDAmbulatory Women's Health Care Registered Nurse
11029274FLMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians Inc Current Accepting new patients
University of Florida Jacksonville Physicians Inc CurrentSince Jul 21, 2025 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Jul 21, 2025 Accepting new patients
Womencare PA Past Accepting new patients

Locations

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

Interoperability endpoints

  • Direct secure messaging: cikem820385@direct.shands.ufl.edu

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1320796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1013294610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 W 6TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322064324",
            "telephone_number": "904-253-2720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 W 6TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322064324",
            "telephone_number": "904-253-2720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IKEM",
        "first_name": "COLETTE",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "MSN, CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-09",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WW0101X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Women's Health Care, Ambulatory",
            "state": "FL",
            "license": "RN9654688",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "FL",
            "license": "11029274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.