Organization Active NPI

Life Tree Women Care, Inc.

  • Obstetrics & Gynecology Physician
  • Jacksonville, FL
National Provider Identifier
1174284038
Registry record updated Sep 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
LIFE TREE WOMEN CARE, INC.
Practice address
5500 Blanding Blvd
Jacksonville, FL 32244-1946
Phone
(904) 379-2540
Fax
(904) 379-2541
NPI assigned
Jan 4, 2022
Last updated
Sep 15, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2026

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

Authorized official

Name
Jamie Leann NealNPI 1023634003
Title
Ceo
Phone
(904) 379-2540

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NU
Advanced Practice Midwife 367A00000X NU
Obstetrics & Gynecology Physician 207V00000X NU Primary

Addresses

Primary practice location

5500 Blanding Blvd
Jacksonville, FL 32244-1946

Mailing address

5500 Blanding Blvd
Jacksonville, FL 32244-1946
Phone (904) 379-2540

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220504002289 FL Part B Supplier - Clinic/Group Practice 0244627552 Receives reassigned benefits from 3 practitioners
Practice locations: Jacksonville, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2257908Life Tree Women Care Inc5500 Blanding Blvd, Jacksonville, FL 32244Provider-performed microscopyApr 12, 2028

National Provider Directory

National Provider Directory

Locations

3625 University Blvd S
Ste 310
Jacksonville, FL 32216

5500 Blanding Blvd
Jacksonville, FL 32244
Phone (844) 310-2247

5500 Blanding Blvd
Ste 1
Jacksonville, FL 32244
Phone (904) 379-2540

6260 103rd St
Ste 5500
Jacksonville, FL 32210

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/25600/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1641254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789430400000",
    "number": "1174284038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 BLANDING BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322441946",
            "telephone_number": "904-379-2540",
            "fax_number": "904-379-2541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 BLANDING BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322441946",
            "telephone_number": "904-379-2540",
            "fax_number": "904-379-2541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE TREE WOMEN CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-04",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A",
        "authorized_official_last_name": "NEAL",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_middle_name": "LEANN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-379-2540"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "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 Sep 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.