Individual provider Active NPI

Patricia Morris Jeter

  • Mental Health Counselor
  • Gainesville, FL
National Provider Identifier
1265666721
Registry record updated Mar 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH10111 Issued in FL
Practice address
4300 SW 13TH St
Gainesville, FL 32608-4006
Phone
(352) 374-5600
NPI assigned
May 12, 2009
Last updated
Mar 18, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X IMH5103 FL
Mental Health Counselor 101YM0800X MH10111 FL Primary

Addresses

Primary practice location

4300 SW 13TH St
Gainesville, FL 32608-4006

Mailing address

4300 SW 13TH St
Gainesville, FL 32608-4006
Phone (352) 374-5600

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241002004228 FL Practitioner - Mental Health Counselor 2264576560 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
IMH5103FLMDCase Manager/Care Coordinator

Practice roles

OrganizationSpecialtyStatusNew patients
Meridian Behavioral Healthcare, Inc. CurrentSince May 25, 2024 Accepting new patients
Meridian Behavioral Healthcare, Inc. CurrentSince May 25, 2024 Accepting new patients

Locations

4300 SW 13th St
Gainesville, FL 32608

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.

NPI Registry JSON

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

{
    "created_epoch": "1242086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268870400000",
    "number": "1265666721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 SW 13TH ST",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326084006",
            "telephone_number": "352-374-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 SW 13TH ST",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326084006",
            "telephone_number": "352-374-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JETER",
        "first_name": "PATRICIA",
        "middle_name": "MORRIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-12",
        "last_updated": "2010-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "FL",
            "license": "IMH5103",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH10111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.