Organization Active NPI

Nola Care, LLC

  • Family Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1083477814
Registry record updated Nov 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
NOLA CARE, LLC
Practice address
13241 Bartram Park Blvd Unit 505
Jacksonville, FL 32258-5213
Phone
(905) 701-3610
Fax
(904) 339-9752
NPI assigned
Feb 5, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2025

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

Authorized official

Name
Ashley Roussell, NPNPI 1326502600
Title
Owner
Phone
(504) 237-7908

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

13241 Bartram Park Blvd Unit 505
Jacksonville, FL 32258-5213

Mailing address

13241 Bartram Park Blvd Unit 505
Jacksonville, FL 32258-5213
Phone (904) 701-3610

Other practice location 1

13241 Bartram Park Blvd Unit 505
Jacksonville, FL 32258-5213
Phone (904) 701-3610

Other names 1

  • NOLA Care LLC Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240710001651 FL Part B Supplier - Clinic/Group Practice 0446795850 Receives reassigned benefits from 2 practitioners
Practice locations: Jacksonville, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2327738Nola Care LLC13241 Bartram Park Blvd Unit 505, Jacksonville, FL 32258Certificate of waiverJul 28, 2027

National Provider Directory

National Provider Directory

Locations

13241 Bartram Park Blvd
Unit 505
Jacksonville, FL 32258
Phone (904) 701-3610

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1707091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763769600000",
    "number": "1083477814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13241 BARTRAM PARK BLVD UNIT 505",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322585213",
            "telephone_number": "904-701-3610",
            "fax_number": "833-972-5105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13241 BARTRAM PARK BLVD UNIT 505",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322585213",
            "telephone_number": "905-701-3610",
            "fax_number": "904-339-9752"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13241 Bartram Park Blvd Unit 505",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322585213",
            "country_code": "US",
            "telephone_number": "904-701-3610",
            "fax_number": "833-972-5105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NOLA CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-05",
        "last_updated": "2025-11-22",
        "certification_date": "2025-11-22",
        "status": "A",
        "authorized_official_last_name": "ROUSSELL",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "504-237-7908",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NOLA Care LLC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "NOLA Care LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.