Jennifer Sullivan Merola, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11000374 Issued in FL

Practice address

211 Ranchera St NW
Live Oak, FL 32064-4866

Phone

(386) 364-1751

Fax

(386) 364-1761

NPI assigned

Apr 10, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Trenton Medical Center Inc

  • Federally Qualified Health Center (FQHC)
  • Trenton, FL
  • NPI 1801826268
  Medicare reassignment NPD
• Trenton Medical Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Fleming Island, FL
  • NPI 1275220238
  NPD
• Trenton Medical Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • High Springs, FL
  • NPI 1588086060
  NPD

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

{
    "created_epoch": "1554854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583107200000",
    "number": "1194288787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23343 NW COUNTY ROAD 236",
            "city": "HIGH SPRINGS",
            "state": "FL",
            "postal_code": "326439669",
            "telephone_number": "386-454-0698",
            "fax_number": "386-454-0690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 RANCHERA ST NW",
            "city": "LIVE OAK",
            "state": "FL",
            "postal_code": "320644866",
            "telephone_number": "386-364-1751",
            "fax_number": "386-364-1761"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "413 5th Ave NW",
            "address_purpose": "LOCATION",
            "city": "Jasper",
            "state": "FL",
            "postal_code": "320527801",
            "country_code": "US",
            "telephone_number": "386-792-0753",
            "fax_number": "386-792-2412",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEROLA",
        "first_name": "JENNIFER",
        "middle_name": "SULLIVAN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-10",
        "last_updated": "2020-03-02",
        "certification_date": "2020-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11000374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmerola@portal.praxisemr.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "413 5th Ave NW",
            "city": "Jasper",
            "state": "FL",
            "country_code": "US",
            "postal_code": "320527801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Felicia Cherry McDaniel
• James M. McMillan, CRPH
• Deanna Lynn Mericle, ARNP
• Meridian Behavioral Healthcare
• Meridian Behavioral Healthcare, Inc.
• Lindsey Allen Minshew, APRN
• Rosalie Delaney Mitchell, LM, CPM
• Leslie Mobley, PTA
• Kochicheril N Moni, M.D.
• Patricia Ann Morgan, RN

• Family Nurse Practitioner in Live Oak, FL
• Providers in Live Oak, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.