Individual provider Active NPI

Chanel Scott, APRN

  • Adult Health Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1053093138
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
11027328 Issued in FL
Practice address
1398 Lindseys Crossing Dr
Jacksonville, FL 32218-8093
Phone
(904) 534-3014
NPI assigned
Aug 7, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 11027328 FL Primary

Addresses

Primary practice location

1398 Lindseys Crossing Dr
Jacksonville, FL 32218-8093

Mailing address

1398 Lindseys Crossing Dr
Jacksonville, FL 32218-8093
Phone (904) 534-3014

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
I20231113002764 FL Practitioner - Nurse Practitioner 1850748823 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
At Home Palliative Care, LLCGroup PAC ID 3274900410, 6 clinicians

Practice addresses (Care Compare)

263 River Hills Dr
Suite 3
Jacksonville, FL 32216-8980
Phone (904) 222-2273

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11027328FLMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
At Home Palliative Care, LLC CurrentSince Nov 1, 2023 Accepting new patients
Ahpc Health Incorporated CurrentSince Nov 17, 2025 Accepting new patients

Locations

263 River Hills Dr
Ste 3
Jacksonville, FL 32216
Phone (904) 222-2272

463688 State Road 200
Ste 1
Yulee, FL 32097
Phone (904) 548-8283

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1691366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1053093138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1398 LINDSEYS CROSSING DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322188093",
            "telephone_number": "904-534-3014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1398 LINDSEYS CROSSING DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322188093",
            "telephone_number": "904-534-3014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "CHANEL",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-07",
        "last_updated": "2023-08-07",
        "certification_date": "2023-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "11027328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.