Organization Active NPI

Focused Wellness Clinic LLC

  • Primary Care Nurse Practitioner
  • Orange Park, FL
National Provider Identifier
1033880232
Registry record updated Nov 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
Legal business name
FOCUSED WELLNESS CLINIC LLC
Practice address
767 Blanding Blvd Ste 105
Orange Park, FL 32065-5788
Phone
(904) 872-4245
Fax
(904) 877-3453
NPI assigned
Sep 27, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2025

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

Authorized official

Name
Constance R Hargrove, APRNNPI 1619416328
Title
Authorized Member
Phone
(904) 872-4245

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2200X
Gerontology Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LG0600X
Primary Care Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP2300X Primary

Addresses

Primary practice location

767 Blanding Blvd Ste 105
Orange Park, FL 32065-5788

Mailing address

767 Blanding Blvd Ste 105
Orange Park, FL 32065-5788
Phone (904) 872-4245

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230203001122 FL Part B Supplier - Clinic/Group Practice 5991177792 Receives reassigned benefits from 1 practitioner
Practice locations: Orange Park, FL

National Provider Directory

National Provider Directory

Locations

767 Blanding Blvd
Ste 105
Orange Park, FL 32065
Phone (904) 872-4245

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1632700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762300800000",
    "number": "1033880232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "767 BLANDING BLVD STE 105",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320655788",
            "telephone_number": "904-872-4245",
            "fax_number": "904-877-3453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "767 BLANDING BLVD STE 105",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320655788",
            "telephone_number": "904-872-4245",
            "fax_number": "904-877-3453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOCUSED WELLNESS CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-27",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A",
        "authorized_official_last_name": "HARGROVE",
        "authorized_official_first_name": "CONSTANCE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "AUTHORIZED MEMBER",
        "authorized_official_telephone_number": "904-872-4245",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.