Individual provider Active NPI

Lynne H Conderman, APRN

  • Adult Health Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1346656709
Registry record updated Nov 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
ARNP9247200 Issued in FL
Practice address
2 Shircliff Way Ste 300
Jacksonville, FL 32204-4765
Phone
(904) 308-2006
Fax
(904) 308-7111
NPI assigned
Jul 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN9247200 FL
Adult Health Nurse Practitioner 363LA2200X APRN9247200 FL
Adult Health Nurse Practitioner 363LA2200X ARNP9247200 FL Primary

Addresses

Primary practice location

2 Shircliff Way Ste 300
Jacksonville, FL 32204-4765

Mailing address

4205 Belfort Rd
Ste 4015
Jacksonville, FL 32216-3623
Phone (904) 450-6017

Other practice location 1

800 Prudential Dr Ste 1100
Jacksonville, FL 32207-8202
Phone (904) 388-6518

Other identifiers 2

IdentifierTypeStateIssuer
012798500MedicaidFL
003151894AMedicaidGA

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
I20140903001922 FL Practitioner - Nurse Practitioner 0840418851 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

655 W 8TH St
Jacksonville, FL 32209-6511
Phone (904) 244-3626

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN9247200FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians, Inc. Current Accepting new patients
Florida Institute of Pain Medicine LLC CurrentSince Sep 1, 2022 Accepting new patients
Florida Institute of Pain Medicine LLC CurrentSince Sep 1, 2022 Accepting new patients
St Vincents Ambulatory Care Inc CurrentSince Jun 1, 2021 Accepting new patients
St Vincents Ambulatory Care Inc CurrentSince Jun 1, 2021 Accepting new patients
Lyerly Baptist Inc PastSince Jun 1, 2025 Accepting new patients
Baptist Neurology Inc PastSince Apr 22, 2019 Accepting new patients

Locations

4205 Belfort Rd
Ste 4015
Jacksonville, FL 32216
Phone (904) 296-5691

4796 Hodges Blvd
Ste 101
Jacksonville, FL 32224
Phone (904) 449-7246

800 Prudential Dr
Fl 11
Jacksonville, FL 32207
Phone (904) 202-4765

3648 University Blvd S
Jacksonville, FL 32216
Phone (904) 345-7185

2 Shircliff Way
Ste 300
Jacksonville, FL 32204
Phone (904) 308-7959

800 Prudential Dr
Fl B11
Jacksonville, FL 32207

580 W 8th St
Jacksonville, FL 32209
Phone (904) 244-3960

800 Prudential Dr
Ste 1100
Jacksonville, FL 32207
Phone (904) 338-6518

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

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

5377 Moncrief Rd
Jacksonville, FL 32209
Phone (904) 768-1506

1280 Henley Rd
Middleburg, FL 32068
Phone (904) 257-1993

1658 St Vincents Way
Ste 310
Middleburg, FL 32068
Phone (904) 308-2006

2145 Kingsley Ave
Orange Park, FL 32073
Phone (904) 272-2424

2029 Professional Center Dr
Orange Park, FL 32073
Phone (570) 352-3063

570 Wells Rd
Orange Park, FL 32073
Phone (904) 264-3912

105 Whitehall Dr
Ste 115
St Augustine, FL 32086
Phone (904) 800-7246

161 Marine St
St Augustine, FL 32084
Phone (904) 829-3475

Organizations & group practices 7

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1404691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1346656709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 BELFORT RD",
            "address_2": "STE 4015",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163623",
            "telephone_number": "904-450-6017",
            "fax_number": "904-450-6041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 SHIRCLIFF WAY STE 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044765",
            "telephone_number": "904-308-2006",
            "fax_number": "904-308-7111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Prudential Dr Ste 1100",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322078202",
            "country_code": "US",
            "telephone_number": "904-388-6518",
            "fax_number": "904-384-1005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONDERMAN",
        "first_name": "LYNNE",
        "middle_name": "H",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-07",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN9247200",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN9247200",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP9247200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012798500",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003151894A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.