Individual provider Active NPI

Jeremy Knight Demille, PA-C

  • Physician Assistant
  • Jacksonville, FL
National Provider Identifier
1154028751
Registry record updated Nov 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9116800 Issued in FL
Practice address
14540 Old Saint Augustine Rd Ste 2207
Jacksonville, FL 32258-7419
Phone
(904) 388-6518
Fax
(904) 384-1005
NPI assigned
Feb 14, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9116800 FL Primary
Surgical Physician Assistant 363AS0400X PA9116800 FL

Addresses

Primary practice location

14540 Old Saint Augustine Rd Ste 2207
Jacksonville, FL 32258-7419

Mailing address

PO Box 746647
Atlanta, GA 30374-6647
Phone (904) 202-2092

Other practice location 1

836 Prudential Dr Ste 1400
Jacksonville, FL 32207-8340
Phone (904) 388-6518

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
I20230316002876 FL Practitioner - Physician Assistant 9638543408 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Lyerly Baptist IncGroup PAC ID 9830112226, 72 clinicians
H2 Rehabilitation Services of Florida LLCGroup PAC ID 3971411851, shared by 10 NPIs, 257 clinicians
Lake Area Physical Therapy Inc.Group PAC ID 3678604840, 372 clinicians

Practice addresses (Care Compare)

1370 13TH Ave S
Jacksonville, FL 32250-3206
Phone (904) 388-6518

484 Riverside Ave
Jacksonville, FL 32202-4912

PO Box
Suite 1099
Melrose, FL 32666-1099

Hospital & facility affiliations

  • Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088
  • Baptist Medical Center - Nassau Hospital, Fernandina Beach, FL, CCN 100140
  • Baptist Medical Center Beaches Hospital, Jacksonville Beach, FL, CCN 100117
  • Ed Fraser Memorial Hospital Hospital, Macclenny, FL, CCN 100134
  • Brooks Rehabilitation Hospital University Campus Inpatient rehabilitation facility, Jacksonville, FL, CCN 103039

Merit-based Incentive Payment System (MIPS)

Final score
81.79 of 100Reported as group
Quality
64.42
Promoting interoperability
100
Improvement activities
40
Cost
74.88

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
North Florida Surgeons, PA CurrentSince May 1, 2023 Accepting new patients
Lyerly Baptist Inc Physician Assistant CurrentSince Jul 3, 2025 Accepting new patients
North Florida Surgeons, PA CurrentSince May 1, 2023 Accepting new patients

Locations

11945 San Jose Blvd
Ste 300
Jacksonville, FL 32223

836 Prudential Dr
Ste 1400
Jacksonville, FL 32207
Phone (904) 396-0000

14540 Old St Augustine Rd
Ste 2571
Jacksonville, FL 32258
Phone (904) 886-2251

14540 Old St Augustine Rd
Ste 2207
Jacksonville, FL 32258
Phone (904) 224-8090

11945 San Jose Blvd
Ste 102
Jacksonville, FL 32223
Phone (904) 268-3937

1370 13th Ave S
Ste 215
Jax Bch, FL 32250
Phone (904) 249-1041

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: jdemille138323@baptisthealthsystemjacksonville.direct-ci.com

Organizations & group practices 4

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1676332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762387200000",
    "number": "1154028751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746647",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746647",
            "telephone_number": "904-202-2092",
            "fax_number": "904-376-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14540 OLD SAINT AUGUSTINE RD STE 2207",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322587419",
            "telephone_number": "904-388-6518",
            "fax_number": "904-384-1005"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "836 Prudential Dr Ste 1400",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322078340",
            "country_code": "US",
            "telephone_number": "904-388-6518",
            "fax_number": "904-384-1005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEMILLE",
        "first_name": "JEREMY",
        "middle_name": "KNIGHT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-02-14",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9116800",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9116800",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.