Individual provider Active NPI

Mary Elizabeth Trask, MSN, NNP, BC

  • Registered Nurse
  • Jacksonville, FL
National Provider Identifier
1164237020
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN91686386 Issued in FL
Practice address
655 W 8TH St
Jacksonville, FL 32209-6511
Phone
(904) 244-3508
NPI assigned
Feb 10, 2025
Last updated
Feb 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN91686386 FL Primary

Addresses

Primary practice location

655 W 8TH St
Jacksonville, FL 32209-6511

Mailing address

1508 Avalon CT
Jacksonville, FL 32259-4517
Phone (904) 424-1677

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
I20250521002760 FL Practitioner - Nurse Practitioner 0042739229 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN91686386FLMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians, Inc. Single Specialty Current Accepting new patients
University of Florida Jacksonville Physicians Inc Single Specialty CurrentSince May 2, 2025 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince May 2, 2025 Accepting new patients

Locations

1443 San Marco Blvd
Jacksonville, FL 32207
Phone (904) 633-4110

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

Interoperability endpoints

  • Direct secure messaging: mtrask791412@direct.shands.ufl.edu

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1739145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1164237020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1508 AVALON CT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322594517",
            "telephone_number": "904-424-1677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 W 8TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096511",
            "telephone_number": "904-244-3508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRASK",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "credential": "MSN, NNP, BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-10",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN91686386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.