Tasha Ellsberry, APRN, FNP, PMHNP-BC
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Jacksonville, FL
NPI 1013466697 · NPPES record last updated Mar 21, 2024
Key facts
- NPI
- 1013466697
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 9344392 (FL)
- Practice address
- 13453 N Main St Ste 104
Jacksonville, FL 32218-2773 - Phone
- (904) 773-4390
- Fax
- (941) 641-7089
- NPI assigned
- Sep 24, 2016
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
- Group practices
- Mental Health Resource Center Inc
Discovery Mental Health Services PA
Amelia Behavioral Wellness LLC
Author Health Professionals, PC
Practice addresses (Care Compare)
11820 Beach Blvd
Jacksonville, FL 32246-6670
Phone (904) 642-9100
13453 N Main St
Suite 104
Jacksonville, FL 32218-2773
Phone (904) 773-4390
1542 Kingsley Ave
Suite 141
Orange Park, FL 32073-4547
Phone (904) 310-9652
360 NW 27TH St
Office/Suite 08 109
Miami, FL 33127-1504
Phone (805) 807-3303
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220201000857 | FL | Practitioner - Nurse Practitioner | 5698168375 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ARNP9344392 | FL | MD | Family Nurse Practitioner |
| 9344392 | FL | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sunshine Mental Healthcare LLC | Psychiatric/Mental Health | Current | Accepting new patients |
| Author Health Professionals, PC | Current |
Accepting new patients | |
| Mental Health Resource Center Inc | Current |
Accepting new patients | |
| Amelia Behavioral Wellness LLC | Current |
Accepting new patients | |
| Discovery Mental Health Services | Mental Health | Current |
Accepting new patients |
Locations
1896 S 14th St
Ste 6
Fernandina Beach, FL 32034
Phone (904) 310-9652
11820 Beach Blvd
Jacksonville, FL 32246
Phone (904) 642-9100
3333 W 20th St
Jacksonville, FL 32254
Phone (904) 384-2364
4427 Emerson St
Ste 5
Jacksonville, FL 32207
Phone (904) 745-0042
13453 N Main St
Ste 104
Jacksonville, FL 32218
Phone (904) 773-4390
360 NW 27th St
#8109
Miami, FL 33127
Phone (805) 807-3303
1542 Kingsley Ave
Ste 141
Orange Park, FL 32073
Phone (904) 278-9828
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Registered Nurse | 163WG0000X | 9344392 | FL | |
| Family Nurse Practitioner | 363LF0000X | ARNP9344392 | FL | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 9344392 | FL | Yes |
Addresses
Primary practice location
13453 N Main St Ste 104
Jacksonville, FL 32218-2773
Mailing address
3333 W 20TH St
Jacksonville, FL 32254-1703
Phone (904) 930-9215
Other providers in Jacksonville, FL
- Troy Townsend Ellis
- Robert G Ellison Jr.
- Eloisa Anne Ello-Esma
- Marylou V Ello
- Joseph Ellow
- Donald Dean Ellsworth
- Oday Ata Elmanaseer
- Omar Elmandouh
- Walneshia Elmore
- Abigaile Eloissaint
All providers in Jacksonville, FL · Psychiatric/Mental Health Nurse Practitioner in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 21, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.