Individual provider Active NPI

Adelajda Kore

  • Physician Assistant
  • Jacksonville, FL
National Provider Identifier
1043894025
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9114110 Issued in NU
Practice address
580 W 8TH St FL 18
Jacksonville, FL 32209-6533
Phone
(904) 244-9189
NPI assigned
May 6, 2021
Last updated
Aug 8, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4909 SC
Physician Assistant 363A00000X PA9114110 NU Primary

Addresses

Primary practice location

580 W 8TH St FL 18
Jacksonville, FL 32209-6533

Mailing address

2118 Willesdon Dr E
Jacksonville, FL 32246-0548
Phone (904) 343-7821

Other practice location 1

3 Richland Medical Park Dr Ste 310
Columbia, SC 29203-6862
Phone (803) 434-8323

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210726002707 FL Practitioner - Physician Assistant 9133522329 Reassigns benefits to 1 organization
I20230822003401 SC Practitioner - Physician Assistant 9133522329 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

15255 Max Leggett Pkwy
Jacksonville, FL 32218-7213
Phone (904) 383-1000

653 W 8TH St
Jacksonville, FL 32209-6511
Phone (904) 244-1680

655 W 8TH St
Jacksonville, FL 32209-6511
Phone (940) 244-4218

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians Inc Neurological Surgery CurrentSince Aug 2, 2021 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Aug 2, 2021 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Jul 20, 2023 Accepting new patients

Locations

580 W 8th St
Fl 18
Jacksonville, FL 32209
Phone (904) 244-9189

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

800 Prudential Dr
Jacksonville, FL 32207
Phone (904) 202-2000

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

3 Richland Medical Park Dr
Ste 310
Columbia, SC 29203
Phone (803) 434-8323

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

Interoperability endpoints

  • Direct secure messaging: akore533197@direct.shands.ufl.edu
  • Direct secure messaging: akore719526@direct.ghs.myhfn.org

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1620259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1043894025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2118 WILLESDON DR E",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322460548",
            "telephone_number": "904-343-7821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 W 8TH ST FL 18",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096533",
            "telephone_number": "904-244-9189"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Richland Medical Park Dr Ste 310",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292036862",
            "country_code": "US",
            "telephone_number": "803-434-8323",
            "fax_number": "803-434-8326",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KORE",
        "first_name": "ADELAJDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-06",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "4909",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": "PA9114110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.