Individual provider Active NPI

Nina Stevens

  • Family Nurse Practitioner
  • Ponte Vedra Beach, FL
National Provider Identifier
1205248309
Registry record updated Aug 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9378669 Issued in FL
Practice address
1102 A1A N
Suite 104
Ponte Vedra Beach, FL 32082-4098
Phone
(904) 273-6533
Fax
(904) 273-6532
NPI assigned
May 22, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP9378669 FL Primary
Pediatric Nurse Practitioner 363LP0200X ARNP9378669 FL

Addresses

Primary practice location

1102 A1A N
Suite 104
Ponte Vedra Beach, FL 32082-4098

Mailing address

1102 A1A N
Suite 104
Ponte Vedra Beach, FL 32082-4098
Phone (904) 273-6533

Other identifiers 1

IdentifierTypeStateIssuer
015285700MedicaidFL

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
I20150728004209 FL Practitioner - Nurse Practitioner 3274847850 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Florida Jacksonville Physicians, Inc.Group PAC ID 9133025869, 908 clinicians

Practice addresses (Care Compare)

4215 Plantation Oaks Blvd
Orange Park, FL 32065-3641
Phone (904) 633-0820

Hospital & facility affiliations

  • Shands Jacksonville Hospital, Jacksonville, FL, CCN 100001

Merit-based Incentive Payment System (MIPS)

Final score
59.59 of 100Reported as apm
Quality
59.93
Promoting interoperability
0
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians Inc CurrentSince Jul 20, 2015 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Jul 20, 2015 Accepting new patients

Locations

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

4215 Plantation Oaks Blvd
Orange Park, FL 32065
Phone (904) 537-3103

Interoperability endpoints

  • Direct secure messaging: nstevens186565@direct.shands.ufl.edu

Organizations & group practices 2

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 2

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": "1400716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440374400000",
    "number": "1205248309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 A1A N",
            "address_2": "SUITE 104",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320824098",
            "telephone_number": "904-273-6533",
            "fax_number": "904-273-6532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 A1A N",
            "address_2": "SUITE 104",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320824098",
            "telephone_number": "904-273-6533",
            "fax_number": "904-273-6532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "NINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-22",
        "last_updated": "2015-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9378669",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "ARNP9378669",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015285700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponte Vedra Beach, FL

Sources for this page

Verify at the official NPI Registry.