Individual provider Active NPI

Taryn Hamilton, APRN

  • Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1063909315
Registry record updated Jan 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
9275694 Issued in FL
Practice address
7406 Fullerton St Ste 105
Jacksonville, FL 32256-3588
Phone
(904) 802-6800
NPI assigned
Apr 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 9275694 FL Primary

Addresses

Primary practice location

7406 Fullerton St Ste 105
Jacksonville, FL 32256-3588

Mailing address

3450 Jessica Mel LN
Jacksonville, FL 32218-6529
Phone (407) 575-8562

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
I20180912003368 FL Practitioner - Nurse Practitioner 2466702444 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9275694FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Christopher Anthony Smith, MD, LLC CurrentSince Jul 1, 2018 Accepting new patients

Locations

616 E Altamonte Dr
Ste 204
Altamonte Springs, FL 32701
Phone (347) 257-7788

8297 Champions Gate Blvd
Champions Gate, FL 33896
Phone (206) 588-5251

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": "1524268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641513600000",
    "number": "1063909315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 JESSICA MEL LN",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322186529",
            "telephone_number": "407-575-8562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7406 FULLERTON ST STE 105",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322563588",
            "telephone_number": "904-802-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "TARYN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-21",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "9275694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.