NPIMap

Organization Active NPI

Night Lite Pediatric Center, LLC

  • Pediatrics Physician
  • Jacksonville, FL
National Provider Identifier
1326708397
Registry record updated Aug 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
NIGHT LITE PEDIATRIC CENTER, LLC
Practice address
11140 Beach Blvd
Jacksonville, FL 32246-4804
Phone
(321) 608-3595
NPI assigned
Dec 17, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2026

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

Authorized official

Name
Kristen Hanly
Title
Director of RCM Operations
Phone
(516) 207-7919

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

11140 Beach Blvd
Jacksonville, FL 32246-4804

Mailing address

1 Hollow LN Ste 301
New Hyde Park, NY 11042-1215
Phone (516) 207-7936

Other identifiers 1

IdentifierTypeStateIssuer
113228411MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Night Lite Pediatric Center LLC9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

11140 Beach Blvd
Jacksonville, FL 32246
Phone (321) 608-3595

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1639699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787184000000",
    "number": "1326708397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOLLOW LN STE 301",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421215",
            "telephone_number": "516-207-7936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11140 BEACH BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322464804",
            "telephone_number": "321-608-3595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NIGHT LITE PEDIATRIC CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-17",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A",
        "authorized_official_last_name": "HANLY",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_title_or_position": "DIRECTOR OF RCM OPERATIONS",
        "authorized_official_telephone_number": "516-207-7919"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113228411",
            "state": "FL"
        }
    ],
    "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 Aug 20, 2026; 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.