Individual provider Active NPI

Jillian Moritz

  • Psychiatric/Mental Health Nurse Practitioner
  • Brentwood, TN
National Provider Identifier
1073269825
Registry record updated Mar 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11011489 Issued in FL
Practice address
555 Church St E Ste 201
Brentwood, TN 37027-4896
Phone
(615) 703-2872
Fax
(561) 516-8554
NPI assigned
Mar 1, 2022
Last updated
Mar 20, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11011489 FL
Family Nurse Practitioner 363LF0000X APRN11011489 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11011489 FL Primary

Addresses

Primary practice location

555 Church St E Ste 201
Brentwood, TN 37027-4896

Mailing address

555 Church St E Ste 201
Brentwood, TN 37027-4896
Phone (716) 462-7811

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
I20221017000286 FL Practitioner - Nurse Practitioner 8628444601 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

608 Sealofts Dr
Apt 304
Boynton Beach, FL 33426-3741

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11011489FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gold Diagnostics Corp CurrentSince Jan 26, 2023 Accepting new patients
Primary Care Solutions & More LLC CurrentSince Sep 16, 2022 Accepting new patients
Wound Technology Network Inc CurrentSince Jun 26, 2023 Accepting new patients
Lindsay Israel, M.D.,P.a. PastSince Jul 21, 2024 Accepting new patients

Locations

3440 Hollywood Blvd
Ste 415
Hollywood, FL 33021
Phone (281) 912-3264

5979 Vineland Rd
Ste 109
Orlando, FL 32819
Phone (407) 270-7702

1701 SE Hillmoor Dr
Ste 7
Port St Lucie, FL 34952
Phone (772) 398-9808

10101 Fondren Rd
Ste 112
Houston, TX 77096
Phone (281) 912-3264

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1646092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773964800000",
    "number": "1073269825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 CHURCH ST E STE 201",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274896",
            "telephone_number": "716-462-7811",
            "fax_number": "561-516-8554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 CHURCH ST E STE 201",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274896",
            "telephone_number": "615-703-2872",
            "fax_number": "561-516-8554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORITZ",
        "first_name": "JILLIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-01",
        "last_updated": "2026-03-20",
        "certification_date": "2026-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11011489",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11011489",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11011489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, TN

Sources for this page

Verify at the official NPI Registry.