Individual provider Active NPI

Rachel Sirois, APRN

  • Family Nurse Practitioner
  • Macclenny, FL
National Provider Identifier
1164034278
Registry record updated Mar 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11008131 Issued in FL
Practice address
531 S 6TH St Ste C
Macclenny, FL 32063-2605
Phone
(904) 687-3021
NPI assigned
Aug 19, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2024

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 APRN11008131 FL Primary

Addresses

Primary practice location

531 S 6TH St Ste C
Macclenny, FL 32063-2605

Mailing address

531 S 6TH St Ste C
Macclenny, FL 32063-2605
Phone (904) 687-3021

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
I20201028001230 FL Practitioner - Nurse Practitioner 6608286976 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rejuvene LLCGroup PAC ID 7719351964, 2 clinicians

Practice addresses (Care Compare)

521 S 6TH St
Macclenny, FL 32063-2605
Phone (904) 478-5790

Hospital & facility affiliations

  • Ed Fraser Memorial Hospital Hospital, Macclenny, FL, CCN 100134

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11008131FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rejuvene LLC Family CurrentSince Nov 8, 2022 Accepting new patients

Locations

531 S 6th St
Macclenny, FL 32063

531 S 6th St
Ste C
Macclenny, FL 32063
Phone (904) 478-5790

521 S 6th St
Macclenny, FL 32063

Interoperability endpoints

  • Direct secure messaging: rachel.sirois.1@31379.direct.athenahealth.com

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.

Hospital & facility affiliations 1

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": "1597795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1164034278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 S 6TH ST STE C",
            "city": "MACCLENNY",
            "state": "FL",
            "postal_code": "320632605",
            "telephone_number": "904-687-3021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531 S 6TH ST STE C",
            "city": "MACCLENNY",
            "state": "FL",
            "postal_code": "320632605",
            "telephone_number": "904-687-3021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIROIS",
        "first_name": "RACHEL",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-19",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11008131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macclenny, FL

Sources for this page

Verify at the official NPI Registry.