Jillian Pona

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11018303 Issued in FL

Practice address

2570 S Atlantic Ave
Daytona Beach Shores, FL 32118-5523

Phone

(386) 872-5442

NPI assigned

Mar 21, 2022

Sex

Female

Sole proprietor

No

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

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.

• Elite Aesthetics, LLC

  dba Elite Aesthetics Skin & Wellness Center

  • Clinic/Center
  • Daytona Beach Shores, FL
  • NPI 1831719756
  NPD

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

{
    "created_epoch": "1647820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651795200000",
    "number": "1083363725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 VOLUNTEER LN",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321743070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2570 S ATLANTIC AVE",
            "city": "DAYTONA BEACH SHORES",
            "state": "FL",
            "postal_code": "321185523",
            "telephone_number": "386-872-5442"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Volunteer Ln",
            "address_purpose": "LOCATION",
            "city": "Ormond Beach",
            "state": "FL",
            "postal_code": "321743070",
            "country_code": "US",
            "telephone_number": "386-795-5563",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PONA",
        "first_name": "JILLIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-21",
        "last_updated": "2022-05-06",
        "certification_date": "2022-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11018303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Brian Meredith
• Jessica Metakes, APRN
• Michael W. Chancellor, M.D., PLLC
• Ronneesha Nichols
• Tamia Phillips, RBT
• Publix Super Markets Inc (Publix Pharmacy #1455)
• Edwidge L Raoul, M.D.
• Cheryl Reiser
• Michael C Ruiz-Thompson
• Marcella Scaccia, MD

• Family Nurse Practitioner in Daytona Beach Shores, FL
• Providers in Daytona Beach Shores, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2022; 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.