Individual provider Active NPI

Brenda Jo Luna, ARNP

  • Family Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1376814483
Registry record updated Nov 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3065882 Issued in FL
Practice address
2627 Riverside Ave
Jacksonville, FL 32204-4712
Phone
(904) 308-7372
Fax
(904) 308-2908
NPI assigned
Jan 20, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3065882 FL Primary

Addresses

Primary practice location

2627 Riverside Ave
Jacksonville, FL 32204-4712

Mailing address

PO Box 864776
Orlando, FL 32886-4776
Phone (904) 308-7372

Other names 1

  • Brenda Jo Craig Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040423000644 FL Practitioner - Nurse Practitioner 2961498993 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3065882FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wound Technology Network Inc CurrentSince Mar 1, 2021 Accepting new patients
St Vincents Ambulatory Care Inc CurrentSince Jul 28, 2012 Accepting new patients
Legacy Family Healthcare Inc Family CurrentSince Feb 27, 2024 Accepting new patients
St Vincents Ambulatory Care Inc CurrentSince Jul 28, 2012 Accepting new patients
Minuteclinic LLC Family CurrentSince Oct 5, 2020 Accepting new patients

Locations

4475 San Juan Ave
Jacksonville, FL 32210
Phone (904) 389-0314

2627 Riverside Ave
Jacksonville, FL 32204
Phone (904) 308-7372

121 W Macclenny Ave
Macclenny, FL 32063
Phone (904) 259-6380

12401 Miramar Pkwy
Miramar, FL 33027
Phone (954) 538-8473

5979 Vineland Rd
Ste 109
Orlando, FL 32819
Phone (407) 270-7702

8765 S Dixie Hwy
Pinecrest, FL 33156
Phone (305) 740-6840

7599 W Sand Lake Rd
Sand Lake, FL 32819
Phone (407) 352-0943

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1327017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383782400000",
    "number": "1376814483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 864776",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328864776",
            "telephone_number": "904-308-7372",
            "fax_number": "904-308-2908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2627 RIVERSIDE AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044712",
            "telephone_number": "904-308-7372",
            "fax_number": "904-308-2908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNA",
        "first_name": "BRENDA",
        "middle_name": "JO",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-20",
        "last_updated": "2013-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "3065882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRENDA",
            "last_name": "CRAIG",
            "middle_name": "JO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.