First Coast Community Wellness Services LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

FIRST COAST COMMUNITY WELLNESS SERVICES LLC

Practice address

5610 Fort Caroline Rd
Jacksonville, FL 32277-1799

Phone

(904) 374-4637

NPI assigned

Jun 15, 2022

Organization subpart

No

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

Authorized official

Name

Monica Johnson, DNPNPI 1851773154

Title

MGR

Phone

(904) 497-2192

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

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

• Monica Johnson, DNP, APRN-C

  • Psychiatric/Mental Health Nurse Practitioner
  • Jacksonville, FL
  • NPI 1851773154

  Single Specialty

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1655251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684800000000",
    "number": "1336879097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11712 PLEASANT CREEK DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322187566",
            "telephone_number": "904-497-2192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5610 FORT CAROLINE RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322771799",
            "telephone_number": "904-374-4637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST COAST COMMUNITY WELLNESS SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-15",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-23",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MONICA",
        "authorized_official_title_or_position": "MGR",
        "authorized_official_telephone_number": "904-497-2192",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• First Coast Caregivers, LLC (Visiting Angels)
• First Coast Community Development
• First Coast Community Development
• First Coast Community Support Services
• First Coast Community Support Services
• First Coast Counseling and Life Coaching, Inc.
• First Coast Counseling and Recovery
• First Coast Dental Center, PLLC
• First Coast Dermatology P a
• First Coast Diabetes Institute, LLC

• Psychiatric/Mental Health Nurse Practitioner in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.