Active NPI
Lynne H Conderman, APRN
- Adult Health Nurse Practitioner
- Jacksonville, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- ARNP9247200
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 012798500 | Medicaid | FL | |
| 003151894A | Medicaid | GA |
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
Enrollment records 1
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
| License | State | Type | Specialty |
|---|---|---|---|
| APRN9247200 | FL | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Florida Jacksonville Physicians, Inc. | Current | Accepting new patients | |
| Florida Institute of Pain Medicine LLC | Current | Accepting new patients | |
| Florida Institute of Pain Medicine LLC | Current | Accepting new patients | |
| St Vincents Ambulatory Care Inc | Current | Accepting new patients | |
| St Vincents Ambulatory Care Inc | Current | Accepting new patients | |
| Lyerly Baptist Inc | Past | Accepting new patients | |
| Baptist Neurology Inc | Past | 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.
-
- Internal Medicine Physician
- Jacksonville, FL
- NPI 1144276452
-
- Neurological Surgery Physician
- Jacksonville, FL
- NPI 1417987124
-
dba Florida Pain Physicians
- Interventional Pain Medicine Physician
- Palm Coast, FL
- NPI 1144913666
-
dba Florida Pain Physicians
- Interventional Pain Medicine Physician
- Jacksonville, FL
- NPI 1194056283
-
dba Ascension St Vincent's Medical Group
- Durable Medical Equipment & Medical Supplies
- Jacksonville, FL
- NPI 1679226690
-
- Neurology Physician
- Jacksonville, FL
- NPI 1598995599
-
- Neurological Surgery Physician
- Jacksonville, FL
- NPI 1740515006
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Urgent Care Clinic/Center
- Jacksonville, FL
- NPI 1144962408
Hospital
-
dba Shands Jacksonville
- General Acute Care Hospital
- Jacksonville, FL
- NPI 1821186313
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.