Individual provider Active NPI

Autumn Delain Jusic, MSN

  • Nurse Practitioner
  • Lake City, FL
National Provider Identifier
1285579672
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11047545 Issued in FL
Practice address
4196 W US Highway 90 Ste 105
Lake City, FL 32055-8834
Phone
(386) 243-8474
NPI assigned
Apr 21, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11047545 FL Primary

Addresses

Primary practice location

4196 W US Highway 90 Ste 105
Lake City, FL 32055-8834

Mailing address

4196 W US Highway 90 Ste 105
Lake City, FL 32055-8834
Phone (386) 243-8474

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2026
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Intensive Care Experts Health Network, LLCGroup PAC ID 6608195599, 99 clinicians

Practice addresses (Care Compare)

701 Victoria St
Brandon, FL 33510-4100
Phone (813) 681-4220

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
11047545FLMDNurse Practitioner

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1776729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1285579672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4196 W US HIGHWAY 90 STE 105",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320558834",
            "telephone_number": "386-243-8474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4196 W US HIGHWAY 90 STE 105",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320558834",
            "telephone_number": "386-243-8474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSIC",
        "first_name": "AUTUMN",
        "middle_name": "DELAIN",
        "name_prefix": "Mrs.",
        "credential": "MSN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-04-21",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11047545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake City, FL

Sources for this page

Verify at the official NPI Registry.