Individual provider Active NPI

Elizabeth Susan Chouinard, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Fleming Island, FL
National Provider Identifier
1376233064
Registry record updated May 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11025948 Issued in FL
Practice address
1699 Waters Edge Dr
Fleming Island, FL 32003-8694
Phone
(904) 469-4289
NPI assigned
May 8, 2023
Last updated
May 8, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11025948 FL Primary

Addresses

Primary practice location

1699 Waters Edge Dr
Fleming Island, FL 32003-8694

Mailing address

1699 Waters Edge Dr
Fleming Island, FL 32003-8694
Phone (904) 469-4289

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
I20230531003365 FL Practitioner - Nurse Practitioner 1254798549 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Thriveworks Clinical - Florida IncGroup PAC ID 5496173577, 85 clinicians
Che Behavioral Health Services of Florida, P.a.Group PAC ID 5698185775, 31 clinicians

Practice addresses (Care Compare)

4243 Sunbeam Rd
Suite 1
Jacksonville, FL 32257-8975
Phone (904) 507-6712

6750 N Andrews Ave
Suite 200
Ft Lauderdale, FL 33309-2180
Phone (888) 515-3834

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11025948FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Thriveworks Clinical - Florida Inc CurrentSince Feb 10, 2025 Accepting new patients
Che Behavioral Health Services of Florida, P.a. Psychiatric/Mental Health CurrentSince May 15, 2023 Accepting new patients

Locations

4243 Sunbeam Rd
Ste 6
Jacksonville, FL 32257
Phone (904) 299-0184

6750 N Andrews Ave
Ste 200
Lauderdale Lakes, FL 33309
Phone (718) 408-5477

4115 W Spruce St
Ste 205
Tampa, FL 33607
Phone (813) 413-4663

1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263

Organizations & group practices 2

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": "1683504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683504000000",
    "number": "1376233064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1699 WATERS EDGE DR",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320038694",
            "telephone_number": "904-469-4289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1699 WATERS EDGE DR",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320038694",
            "telephone_number": "904-469-4289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOUINARD",
        "first_name": "ELIZABETH",
        "middle_name": "SUSAN",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-08",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11025948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fleming Island, FL

Sources for this page

Verify at the official NPI Registry.