Individual provider Active NPI

Lindsay Vines, APRN

  • Nurse Practitioner
  • Jacksonville Beach, FL
National Provider Identifier
1093540528
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11035079 Issued in FL
Practice address
1361 13TH Ave S Ste 180
Jacksonville Beach, FL 32250-3235
Phone
(850) 247-4300
NPI assigned
Sep 4, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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 11035079 FL Primary

Addresses

Primary practice location

1361 13TH Ave S Ste 180
Jacksonville Beach, FL 32250-3235

Mailing address

1361 13TH Ave S Ste 180
Jacksonville Beach, FL 32250-3235
Phone (850) 247-4300

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
I20240925003359 FL Practitioner - Nurse Practitioner 0143761536 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Group of Florida, P.a.Group PAC ID 1153367107, 54 clinicians

Practice addresses (Care Compare)

1611 NW 12 Ave
Miami, FL 33136-1005
Phone (305) 585-1111

720 Cortaro Dr
Sun City Center, FL 33573-6811
Phone (813) 877-4811

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11035079FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Group of Florida, P.a. CurrentSince Sep 5, 2024 Accepting new patients

Locations

1001 NW 13th St
Ste 100
Boca Raton, FL 33486
Phone (561) 750-0544

13732 17th St
Dade City, FL 33525
Phone (800) 809-4811

4000 Hollywood Blvd
Ste 215S
Hollywood, FL 33021
Phone (954) 807-9332

1361 13th Ave S
Ste 180
Jax Bch, FL 32250
Phone (904) 247-4300

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

4200 N Armenia Ave
Ste 12
Tampa, FL 33607
Phone (813) 877-4811

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": "1725408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1093540528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1361 13TH AVE S STE 180",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322503235",
            "telephone_number": "850-247-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1361 13TH AVE S STE 180",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322503235",
            "telephone_number": "850-247-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINES",
        "first_name": "LINDSAY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-04",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11035079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville Beach, FL

Sources for this page

Verify at the official NPI Registry.