Individual provider Active NPI

Corinne Ruth Padgett, PA-C

  • Physician Assistant
  • Jacksonville, FL
National Provider Identifier
1235604836
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9111795 Issued in FL
Practice address
14534 Old Saint Augustine Rd Ste 3210
Jacksonville, FL 32258-2645
Phone
(904) 675-4000
Fax
(904) 675-4007
NPI assigned
Oct 10, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9111795 FL Primary

Addresses

Primary practice location

14534 Old Saint Augustine Rd Ste 3210
Jacksonville, FL 32258-2645

Mailing address

11945 San Jose Blvd Ste 300
Jacksonville, FL 32223-1627
Phone (904) 396-1725

Other practice location 1

5191 First Coast Tech Pkwy Fl 3
Jacksonville, FL 32224-0609
Phone (904) 675-4000

Other names 1

  • Miss Corinne Ruth Gratien Former name

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
I20190213003017 FL Practitioner - Physician Assistant 8628316825 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Florida Surgeons PAGroup PAC ID 2769381391, 336 clinicians

Practice addresses (Care Compare)

11945 San Jose Blvd
Jacksonville, FL 32223-1627
Phone (904) 396-1725

14534 Old Saint Augustine Rd
Suite 3210
Jacksonville, FL 32258-2645
Phone (904) 880-1260

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9111795FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
North Florida Surgeons, PA CurrentSince Jun 8, 2025 Accepting new patients
North Florida Surgeons, PA CurrentSince Jun 8, 2025 Accepting new patients

Locations

36468 Emerald Coast Pkwy
Ste 1101
Destin, FL 32541
Phone (850) 290-2154

1340 S 18th St
Ste 104
Fernandina Beach, FL 32034
Phone (904) 277-3277

11945 San Jose Blvd
Ste 300
Jacksonville, FL 32223

14534 Old St Augustine Rd
Ste 3210
Jacksonville, FL 32258
Phone (904) 880-1260

5191 First Coast Tech Pkwy
Fl 3
Jacksonville, FL 32224
Phone (904) 222-3332

11945 San Jose Blvd
Ste 102
Jacksonville, FL 32223
Phone (904) 268-3937

Interoperability endpoints

  • Direct secure messaging: corinne.padgett.1@9109.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1539129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780358400000",
    "number": "1235604836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11945 SAN JOSE BLVD STE 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322231627",
            "telephone_number": "904-396-1725",
            "fax_number": "904-396-5676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14534 OLD SAINT AUGUSTINE RD STE 3210",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322582645",
            "telephone_number": "904-675-4000",
            "fax_number": "904-675-4007"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5191 First Coast Tech Pkwy Fl 3",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322240609",
            "country_code": "US",
            "telephone_number": "904-675-4000",
            "fax_number": "904-675-4007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PADGETT",
        "first_name": "CORINNE",
        "middle_name": "RUTH",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-10",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9111795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CORINNE",
            "last_name": "GRATIEN",
            "middle_name": "RUTH",
            "prefix": "MISS",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.