Individual provider Active NPI

Cherie Danielle Nicholson, APRN

  • Family Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1124683214
Registry record updated Jun 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11002277 Issued in FL
Practice address
1900 Corporate Square Blvd
Jacksonville, FL 32216-1941
Phone
(904) 899-4500
NPI assigned
May 5, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11002277 FL Primary

Addresses

Primary practice location

1900 Corporate Square Blvd
Jacksonville, FL 32216-1941

Mailing address

1900 Corporate Square Blvd
Jacksonville, FL 32216-1941
Phone (904) 899-4500

Other practice location 1

1100 Cesery Blvd
Jacksonville, FL 32211-5674
Phone (904) 551-5884

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11002277FLMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1557014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623024000000",
    "number": "1124683214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 CORPORATE SQUARE BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322161941",
            "telephone_number": "904-899-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 CORPORATE SQUARE BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322161941",
            "telephone_number": "904-899-4500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Cesery Blvd",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322115674",
            "country_code": "US",
            "telephone_number": "904-551-5884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "CHERIE",
        "middle_name": "DANIELLE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-05",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11002277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jun 7, 2021; 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.