Jourdan Ashley Clum, ARNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

APRN11030275 Issued in FL

Practice address

1859 SW Newland Way
Lake City, FL 32025-6966

Phone

(386) 758-0003

NPI assigned

Jan 8, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JEBAED/Endpoint/JEBAED
• Direct secure messaging: jourdan.clum.p1@direct.nfpeds.nextgenshare.com

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.

• North Florida Pediatrics, PA

  • Rural Health Clinic/Center
  • Jasper, FL
  • NPI 1033114285
  NPD (past)

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

{
    "created_epoch": "1704672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1073383345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19851 NW 257TH TER",
            "city": "HIGH SPRINGS",
            "state": "FL",
            "postal_code": "326432044",
            "telephone_number": "135-272-7165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1859 SW NEWLAND WAY",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320256966",
            "telephone_number": "386-758-0003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLUM",
        "first_name": "JOURDAN",
        "middle_name": "ASHLEY",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-08",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "APRN11030275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Brooke Clayton
• Clearsky Rehabilitation Hospital of Lake City LLC
• Brittni Cleland, R-DMT
• Clinical Pet of Lake City
• Club Community Care LLC
• CMS Professional Transport, Inc.
• Coast Dental P.a.
• Coast Multi-Specialty Medical Group P.a
• Melissa Sue Cobb
• Morgan Renald Cobran, D.D.S.

• Pediatric Nurse Practitioner in Lake City, FL
• Providers in Lake City, FL by specialty
• Pediatric Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.