Individual provider Active NPI

Jaylen Payne, DNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Lake Mary, FL
National Provider Identifier
1154174118
Registry record updated Jan 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN11043349 Issued in FL
Practice address
525 Technology Park Ste 109
Lake Mary, FL 32746-7107
Phone
(407) 647-2346
NPI assigned
Apr 9, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11043349 FL Primary
Registered Nurse 163W00000X 913738 MS

Addresses

Primary practice location

525 Technology Park Ste 109
Lake Mary, FL 32746-7107

Mailing address

8801 Pathstone Blvd Apt 2403
Pensacola, FL 32526-4557
Phone (662) 304-6580

Other practice location 1

8801 Pathstone Blvd Apt 2403
Pensacola, FL 32526-4557
Phone (662) 304-6580

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
I20260130001982 FL Practitioner - Nurse Practitioner 4284112327 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr Luisa Vega DNP LLCGroup PAC ID 3577872605, 83 clinicians

Practice addresses (Care Compare)

1044 E Brandon Blvd
Suite 1And2
Brandon, FL 33511-5509
Phone (813) 403-4423

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
913738MSMDRegistered Nurse
APRN11043349FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Luisa Vega DNP LLC Psychiatric/Mental Health CurrentSince Feb 1, 2026 Accepting new patients

Locations

1044 E Brandon Blvd
Ste 12
Brandon, FL 33511
Phone (813) 403-4423

525 Technology Park
Ste 109
Lake Mary, FL 32746
Phone 4076472346 ext. 111

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": "1712620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769126400000",
    "number": "1154174118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8801 PATHSTONE BLVD APT 2403",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325264557",
            "telephone_number": "662-304-6580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 TECHNOLOGY PARK STE 109",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327467107",
            "telephone_number": "407-647-2346"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8801 Pathstone Blvd Apt 2403",
            "address_purpose": "LOCATION",
            "city": "Pensacola",
            "state": "FL",
            "postal_code": "325264557",
            "country_code": "US",
            "telephone_number": "662-304-6580",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "JAYLEN",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-04-09",
        "last_updated": "2026-01-23",
        "certification_date": "2026-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11043349",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MS",
            "license": "913738",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

Verify at the official NPI Registry.