Individual provider Active NPI

Baylee Joudi

  • Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1154943587
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11006101 Issued in FL
Practice address
14453 Beach Blvd Ste 103
Jacksonville, FL 32250-2081
Phone
(904) 619-7078
NPI assigned
May 7, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN11006101 FL Primary

Addresses

Primary practice location

14453 Beach Blvd Ste 103
Jacksonville, FL 32250-2081

Mailing address

4753 Kerle St
Jacksonville, FL 32205-4903
Phone (904) 214-5121

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
APRN11006101FLMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1588809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1154943587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4753 KERLE ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322054903",
            "telephone_number": "904-214-5121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14453 BEACH BLVD STE 103",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322502081",
            "telephone_number": "904-619-7078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOUDI",
        "first_name": "BAYLEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-07",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11006101",
            "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 Dec 8, 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.