Individual provider Active NPI

Ericka Burnett, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1093586406
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11030652 Issued in FL
Practice address
10299 Magnolia Ridge Dr
Jacksonville, FL 32210-4991
Phone
(904) 624-2912
NPI assigned
Jan 15, 2024
Last updated
Sep 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11030652 FL Primary

Addresses

Primary practice location

10299 Magnolia Ridge Dr
Jacksonville, FL 32210-4991

Mailing address

10299 Magnolia Ridge Dr
Jacksonville, FL 32210-4991
Phone (904) 624-2912

Other practice location 1

725 N 12th Ave Bldg B
Arcadia, FL 34266-8752
Phone (941) 776-4000

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
I20240821001671 FL Practitioner - Nurse Practitioner 5092253021 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Balanced Wellbeing LLCGroup PAC ID 5193021848, 228 clinicians

Practice addresses (Care Compare)

22385 Flora Parke Xing
Fernandina Beach, FL 32034-8000
Phone (904) 404-8641

3200 SW 34TH Ave
Suite 701
Ocala, FL 34474-8443
Phone (877) 779-2429

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11030652FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Community Health Services, Inc. CurrentSince Dec 1, 2024 Accepting new patients
MCR Health, Inc. CurrentSince Sep 11, 2024 Accepting new patients
Balanced Wellbeing LLC CurrentSince Aug 12, 2024 Accepting new patients
MCR Health, Inc. CurrentSince Sep 11, 2024 Accepting new patients
Coastal Community Health Services, Inc. CurrentSince Dec 1, 2024 Accepting new patients

Locations

725 N 12th Ave
Bldg B
Arcadia, FL 34266
Phone (863) 494-1242

22385 Flora Parke Xing
Fernandina Beach, FL 32034
Phone (904) 404-8641

3200 SW 34th Ave
Ste 701
Ocala, FL 34474
Phone (354) 445-1200

12271 US Highway 301 N
Parrish, FL 34219
Phone (941) 713-2231

106 Shoppers Way
Ste 101
Brunswick, GA 31525
Phone (912) 275-8208

1022 Miller Ln SW
Darien, GA 31305
Phone (912) 257-8028

Organizations & group practices 5

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": "1705276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1093586406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10299 MAGNOLIA RIDGE DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322104991",
            "telephone_number": "904-624-2912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10299 MAGNOLIA RIDGE DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322104991",
            "telephone_number": "904-624-2912"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "725 N 12th Ave Bldg B",
            "address_purpose": "LOCATION",
            "city": "Arcadia",
            "state": "FL",
            "postal_code": "342668752",
            "country_code": "US",
            "telephone_number": "941-776-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURNETT",
        "first_name": "ERICKA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-15",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11030652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.