Active NPI
Kenya Leyva, APRN
- Family Nurse Practitioner
- Jacksonville, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 11023704
- Practice address
- 2624 Atlantic Blvd
Jacksonville, FL 32207-3609 - Phone
- (904) 513-3240
- Fax
- (904) 398-7871
- NPI assigned
- Dec 27, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 11023704 | FL | Primary |
Addresses
Primary practice location
2624 Atlantic Blvd
Jacksonville, FL 32207-3609
Mailing address
13990 Bartram Park Blvd Unit 2107
Jacksonville, FL 32258-5573
Phone (786) 302-9296
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2624 Atlantic Blvd
Suite 1
Jacksonville, FL 32207-3633
Phone (904) 513-3240
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11023704 | FL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Omega Health and Nutrition LLC | Current | Accepting new patients |
Locations
2624 Atlantic Blvd
Ste 1
Jacksonville, FL 32207
Phone (904) 413-3360
2624 Atlantic Blvd
Ste 6
Jacksonville, FL 32207
Phone (904) 513-3240
2624 Atlantic Blvd
Jacksonville, FL 32207
Phone (904) 513-3240
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.
-
- Pulmonary Disease Physician
- Jacksonville, FL
- NPI 1912219064
-
- Nutritionist
- Jacksonville, FL
- NPI 1134619208
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1672099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705276800000",
"number": "1265145932",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13990 BARTRAM PARK BLVD UNIT 2107",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322585573",
"telephone_number": "786-302-9296"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2624 ATLANTIC BLVD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322073609",
"telephone_number": "904-513-3240",
"fax_number": "904-398-7871"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEYVA",
"first_name": "KENYA",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-12-27",
"last_updated": "2024-01-15",
"certification_date": "2024-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "FL",
"license": "11023704",
"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 Jan 15, 2024; 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.
- 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.