Individual provider Active NPI

Jessica Eads

  • Adult Health Nurse Practitioner
  • Palm Coast, FL
National Provider Identifier
1093675639
Registry record updated Jul 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APRN11048965 Issued in FL
Practice address
80 Pinnacles Dr Ste 700
Palm Coast, FL 32164-2915
Phone
(386) 387-8500
Fax
(386) 387-8511
NPI assigned
Nov 17, 2025
Last updated
Jul 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Clinical Nurse Specialist 364SM0705X 253073 SC
Adult Health Nurse Practitioner 363LA2200X APRN11048965 FL Primary

Addresses

Primary practice location

80 Pinnacles Dr Ste 700
Palm Coast, FL 32164-2915

Mailing address

7751 Belfort Pkwy Ste 350
Jacksonville, FL 32256-6951
Phone (904) 363-7453

Other practice location 1

3000 Saint Matthews Rd
Orangeburg, SC 29118-1442
Phone (803) 395-2291

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
253073SCMDMedical-Surgical Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1763337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783468800000",
    "number": "1093675639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7751 BELFORT PKWY STE 350",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566951",
            "telephone_number": "904-363-7453",
            "fax_number": "904-538-3672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 PINNACLES DR STE 700",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321642915",
            "telephone_number": "386-387-8500",
            "fax_number": "386-387-8511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3000 Saint Matthews Rd",
            "address_purpose": "LOCATION",
            "city": "Orangeburg",
            "state": "SC",
            "postal_code": "291181442",
            "country_code": "US",
            "telephone_number": "803-395-2291",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EADS",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-17",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SM0705X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Medical-Surgical",
            "state": "SC",
            "license": "253073",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN11048965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Coast, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2026; 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.