Individual provider Active NPI

Lindsay Marie Jaghab, APRN, FNP-C

  • Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1306459243
Registry record updated Feb 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11011566 Issued in FL
Practice address
4085 Town Center Pkwy
Jacksonville, FL 32246-8580
Phone
(904) 202-6760
NPI assigned
Aug 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X 9436492 FL
Nurse Practitioner 363L00000X 11011566 FL Primary

Addresses

Primary practice location

4085 Town Center Pkwy
Jacksonville, FL 32246-8580

Mailing address

10550 Baymeadows Rd Unit 403
Jacksonville, FL 32256-4520
Phone (904) 476-8898

Other practice location 1

800 Prudential Dr
Jacksonville, FL 32207-8211
Phone (904) 202-2000

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
9436492FLMDEmergency Registered Nurse
11011566FLMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1598745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613433600000",
    "number": "1306459243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10550 BAYMEADOWS RD UNIT 403",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322564520",
            "telephone_number": "904-476-8898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4085 TOWN CENTER PKWY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322468580",
            "telephone_number": "904-202-6760"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Prudential Dr",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322078211",
            "country_code": "US",
            "telephone_number": "904-202-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAGHAB",
        "first_name": "LINDSAY",
        "middle_name": "MARIE",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-30",
        "last_updated": "2021-02-16",
        "certification_date": "2021-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "FL",
            "license": "9436492",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11011566",
            "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 Feb 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.