Dorothea Myles Jattan, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

11033775 Issued in FL

Practice address

4510 Water Oak LN
Jacksonville, FL 32210-7535

Phone

(305) 978-4309

NPI assigned

Jul 2, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Emdr Trauma Therapy Center LLCGroup PAC ID 8123470192, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Emdr Trauma Therapy Center LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fleming Island, FL
  • NPI 1407474943
  Medicare reassignment Care Compare group NPD
• Mind Matters Psychiatry LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Jacksonville, FL
  • NPI 1851190011
  NPD Authorized official

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

{
    "created_epoch": "1719878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1013753839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4510 WATER OAK LN",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322107535",
            "telephone_number": "305-978-4309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4510 WATER OAK LN",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322107535",
            "telephone_number": "305-978-4309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JATTAN",
        "first_name": "DOROTHEA",
        "middle_name": "MYLES",
        "name_prefix": "Ms.",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-02",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11033775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason'S Place Aja LLC
• Kathleen Jasper, ARNP, CRNA
• Madison Jasper
• Bharti Jasra, M.D.
• Wilson Jativa, RN
• Jason Lee Jaudon, CRNA
• Sonia Javani, PSY.D.
• Faiza Javed, O.D.
• Imran Javed, MD
• Adrian Javier, DPT

• Psychiatric/Mental Health Nurse Practitioner in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.