Individual provider Active NPI

James Tully, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1053933903
Registry record updated Oct 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN11007103 Issued in FL
Practice address
9889 Gate Pkwy N Ste 305
Jacksonville, FL 32246-9230
Phone
(904) 725-6463
NPI assigned
May 14, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X APRN11007103 FL Primary

Addresses

Primary practice location

9889 Gate Pkwy N Ste 305
Jacksonville, FL 32246-9230

Mailing address

9889 Gate Pkwy N Ste 305
Jacksonville, FL 32246-9230

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
I20200617002177 FL Practitioner - Nurse Practitioner 6709208960 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Artistic Psychiatric Associates LLCGroup PAC ID 6608114335, 8 clinicians

Practice addresses (Care Compare)

9889 Gate Pkwy N
Suite 305
Jacksonville, FL 32246-9230
Phone (904) 725-6463

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11007103FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Artistic Psychiatric Associates LLC Single Specialty CurrentSince May 15, 2020 Accepting new patients

Locations

9550 Regency Square Blvd
Ste 903
Jacksonville, FL 32225
Phone (561) 523-9392

9889 Gate Pkwy N
Ste 305
Jacksonville, FL 32246
Phone (904) 725-6463

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.

NPI Registry JSON

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

{
    "created_epoch": "1589414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697673600000",
    "number": "1053933903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9889 GATE PKWY N STE 305",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322469230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9889 GATE PKWY N STE 305",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322469230",
            "telephone_number": "904-725-6463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TULLY",
        "first_name": "JAMES",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-14",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11007103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.