Individual provider Active NPI

Stephanie Parks, ARNP

  • Nurse Practitioner
  • Middleburg, FL
National Provider Identifier
1386345387
Registry record updated Mar 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11024496 Issued in FL
Practice address
1670 St Vincents Way
Middleburg, FL 32068-8447
Phone
(904) 602-1400
NPI assigned
Mar 15, 2023
Last updated
Mar 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11024496 FL Primary

Addresses

Primary practice location

1670 St Vincents Way
Middleburg, FL 32068-8447

Mailing address

2246 Club Lake Dr
Orange Park, FL 32065-2644
Phone (321) 368-4332

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
I20230801001023 FL Practitioner - Nurse Practitioner 9739540253 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiorenal Therapeutics LLCGroup PAC ID 7416280425, 34 clinicians

Practice addresses (Care Compare)

6817 Southpoint Pkwy
Suite 203
Jacksonville, FL 32216-6286
Phone (904) 330-1024

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
70.94
Improvement activities
40
Cost
92.94

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11024496FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC CurrentSince Jun 21, 2023 Accepting new patients
Florida Institute of Pain Medicine LLC CurrentSince Mar 21, 2024 Accepting new patients
Florida Institute of Pain Medicine LLC CurrentSince Mar 21, 2024 Accepting new patients
Cep America, LLC Current Accepting new patients
Cardiorenal Therapeutics LLC CurrentSince Dec 1, 2024 Accepting new patients
Cep America LLC CurrentSince Jun 21, 2023 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 900-3125

2061 Hyde Park Rd
Jacksonville, FL 32210
Phone (904) 553-3601

3648 University Blvd S
Jacksonville, FL 32216
Phone (904) 519-9233

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

6817 Southpoint Pkwy
Ste 203
Jacksonville, FL 32216
Phone (904) 256-9202

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

1670 St Vincents Way
Middleburg, FL 32068
Phone (904) 308-1219

7800 US Highway 98 W
Miramar Beach, FL 32550
Phone (850) 267-1603

2029 Professional Center Dr
Orange Park, FL 32073
Phone (904) 264-8621

2145 Kingsley Ave
Orange Park, FL 32073
Phone (904) 264-3912

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

25 State Road 13 N
St Johns, FL 32259
Phone (904) 265-8209

Organizations & group practices 6

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": "1678838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1386345387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2246 CLUB LAKE DR",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320652644",
            "telephone_number": "321-368-4332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1670 ST VINCENTS WAY",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "320688447",
            "telephone_number": "904-602-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKS",
        "first_name": "STEPHANIE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-15",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11024496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middleburg, FL

Sources for this page

Verify at the official NPI Registry.