Individual provider Active NPI

Fernique Jean-Jacques, NP

  • Family Nurse Practitioner
  • West Palm Beach, FL
National Provider Identifier
1174918403
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN9162415 Issued in FL
Practice address
1150 45TH St
West Palm Beach, FL 33407-2361
Phone
(561) 642-1000
Fax
(561) 804-5629
NPI assigned
Apr 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X APRN9162415 FL
Family Nurse Practitioner 363LF0000X APRN9162415 FL Primary

Addresses

Primary practice location

1150 45TH St
West Palm Beach, FL 33407-2361

Mailing address

1515 N Flagler Dr
West Palm Beach, FL 33401-3428
Phone (561) 642-1000

Other identifiers 1

IdentifierTypeStateIssuer
015093500MedicaidFL

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
I20150729008998 FL Practitioner - Nurse Practitioner 1759695158 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
May accept Medicare assignment
Group practices
District Clinic Holdings IncGroup PAC ID 4486876000, 15 clinicians

Practice addresses (Care Compare)

1150 45TH St
West Palm Beach, FL 33407-2361
Phone (561) 842-7383

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN9162415FLMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
West Palm Beach Physician Group Inc CurrentSince Jun 22, 2015 Accepting new patients
District Clinic Holdings Inc Past Accepting new patients

Locations

800 Meadows Rd
Boca Raton, FL 33486
Phone (561) 395-7100

5301 S Congress Ave
Lantana, FL 33462
Phone (561) 548-3549

2201 45th St
West Palm Beach, FL 33407
Phone (561) 842-6141

10101 Forest Hill Blvd
West Palm Beach, FL 33414
Phone (561) 766-1301

13001 State Road 80
Westlake, FL 33470
Phone (561) 793-3300

Organizations & group practices 11

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": "1427932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776211200000",
    "number": "1174918403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 N FLAGLER DR",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334013428",
            "telephone_number": "561-642-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 45TH ST",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334072361",
            "telephone_number": "561-642-1000",
            "fax_number": "561-804-5629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEAN-JACQUES",
        "first_name": "FERNIQUE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-02",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "APRN9162415",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9162415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015093500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.