Individual provider Active NPI

Christy Cormier, APRN

  • Acute Care Nurse Practitioner
  • Orange Park, FL
National Provider Identifier
1336811801
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
11014124 Issued in FL
Practice address
1536 Kingsley Ave Ste 118
Orange Park, FL 32073-4525
Phone
(904) 298-2113
NPI assigned
Oct 1, 2021
Last updated
Mar 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 11014124 FL Primary

Addresses

Primary practice location

1536 Kingsley Ave Ste 118
Orange Park, FL 32073-4525

Mailing address

2418 Oakview Dr
Jacksonville, FL 32246-2462

Other names 1

  • Christy Pryor Former name

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211014002829 FL Practitioner - Nurse Practitioner 1456759893 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Infectious Disease Associates PAGroup PAC ID 3971566365, 6 clinicians

Practice addresses (Care Compare)

1536 Kingsley Ave
Suite 118
Orange Park, FL 32073-4525
Phone (904) 298-2113

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11014124FLMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Infectious Disease Associates PA CurrentSince May 10, 2022 Accepting new patients
Respiratory Critical Care and Sleep Medicine Associates,Inc CurrentSince Oct 1, 2021 Accepting new patients
National Kidney Partners, LLP CurrentSince Dec 27, 2022 Accepting new patients

Locations

14134 Nephron Ln
Hudson, FL 34667
Phone (727) 863-5418

1325 San Marco Blvd
Jacksonville, FL 32207
Phone (904) 253-6910

1325 San Marco Blvd
Ste 300
Jacksonville, FL 32207
Phone (904) 202-4243

1443 San Marco Blvd
Ste 101
Jacksonville, FL 32207
Phone (904) 253-6910

1536 Kingsley Ave
Ste 118
Orange Park, FL 32073
Phone (904) 298-2113

2140 Kingsley Ave
Ste 10
Orange Park, FL 32073
Phone (904) 529-5252

Interoperability endpoints

  • Direct secure messaging: ccormier78952@direct.acumenmd.com

Organizations & group practices 3

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": "1633046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1336811801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2418 OAKVIEW DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322462462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1536 KINGSLEY AVE STE 118",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734525",
            "telephone_number": "904-298-2113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORMIER",
        "first_name": "CHRISTY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-01",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "11014124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTY",
            "last_name": "PRYOR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Orange Park, FL

Sources for this page

Verify at the official NPI Registry.