Sara Kramer-Wallace, ARNP
Individual provider Active NPI Family Nurse Practitioner · Jacksonville, FL
NPI 1275968836 · NPPES record last updated Oct 9, 2018
Key facts
- NPI
- 1275968836
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- ARNP9303473 (FL)
- Practice address
- 2627 Riverside Ave
Jacksonville, FL 32204-4712 - Phone
- (904) 308-7372
- Fax
- (904) 308-2908
- NPI assigned
- Sep 13, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- St Vincents Medical Center Inc
Practice addresses (Care Compare)
2627 Riverside Ave
Jacksonville, FL 32204-4712
Phone (904) 308-7372
Hospital & facility affiliations
- Ascension St Vincent'S Riverside
- Ascension St Vincent'S Clay County
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181120001101 | FL | Practitioner - Nurse Practitioner | 7517211097 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ARNP9303473 | FL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Vincents Medical Center Inc | Current |
Accepting new patients | |
| St Vincents Medical Center Inc | Current |
Accepting new patients |
Locations
2627 Riverside Ave
Jacksonville, FL 32204
Phone (904) 308-7372
Interoperability endpoints
- sara.kramer-wallace.1@8967.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | ARNP9303473 | FL | Yes |
Addresses
Primary practice location
2627 Riverside Ave
Jacksonville, FL 32204-4712
Mailing address
4205 Belfort Rd Ste 4015
Jacksonville, FL 32216-3623
Other providers in Jacksonville, FL
- Nicholas Krake
- Sandra Kral
- Ann Desloge Kramarich
- Stephen Scott Kramarich
- Rebecca Joann Kramb
- Aria L Kramer
- Christopher Lawrence Kramer
- Deshire Kramer
- Jenna Kramer
- Jennifer Kramer
All providers in Jacksonville, FL · Family Nurse Practitioner in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 9, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.