Active NPI
Kellyanne Saoirse Jaber, LM, CPM
- Midwife
- Jacksonville, FL
National Provider Identifier
1053808592
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Midwife
- License
- MW361
- Practice address
- 7117 Blache CT
Jacksonville, FL 32210-4868 - Phone
- (904) 990-3619
- Fax
- (904) 562-3402
- NPI assigned
- Apr 19, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Midwife | 176B00000X | MW361 | FL | Primary |
Addresses
Primary practice location
7117 Blache CT
Jacksonville, FL 32210-4868
Mailing address
1715 Spring Star CT
Jacksonville, FL 32221-7638
Phone (727) 967-0866
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MW361 | FL | MD | Midwife |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| First Coast Midwifery Services LLC | Midwife | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Midwife
- Jacksonville, FL
- NPI 1437656303
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1524096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1524096000000",
"number": "1053808592",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1715 SPRING STAR CT",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322217638",
"telephone_number": "727-967-0866"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7117 BLACHE CT",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322104868",
"telephone_number": "904-990-3619",
"fax_number": "904-562-3402"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JABER",
"first_name": "KELLYANNE",
"middle_name": "SAOIRSE",
"credential": "LM, CPM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-19",
"last_updated": "2018-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "FL",
"license": "MW361",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.