Individual provider Active NPI

Emily J Ernst, DPM

  • Foot & Ankle Surgery Podiatrist
  • Fleming Island, FL
National Provider Identifier
1407019839
Registry record updated Sep 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO3484 Issued in FL
Practice address
1677 Eagle Harbor Pkwy
Suite C
Fleming Island, FL 32003-4802
Phone
(904) 278-5112
Fax
(904) 278-5874
NPI assigned
Jul 7, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X PO3484 FL Primary
Foot & Ankle Surgery Podiatrist 213ES0103X SC006047 PA

Addresses

Primary practice location

1677 Eagle Harbor Pkwy
Suite C
Fleming Island, FL 32003-4802

Mailing address

1677 Eagle Harbor Pkwy
Suite C
Fleming Island, FL 32003-4802
Phone (904) 278-5112

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110721000643 FL Practitioner - Podiatry 6305014192 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jande Jackson Enterprises, PLLCGroup PAC ID 0345541314, 2 clinicians

Practice addresses (Care Compare)

1677 Eagle Harbor Pkwy
Suite C
Fleming Island, FL 32003-4845
Phone (904) 278-5112

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue59
Removal of skin lesions125
Removal of nail tissue399
Removal or shaving of skin growth112
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC006047PAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
J&E Jackson Enterprises, PLLC Foot & Ankle Surgery CurrentSince Jul 21, 2015 Accepting new patients
Janet L Black D P M P a PastSince Jan 2, 2007 Accepting new patients
Yhn 1, LLC PastSince May 7, 2023 Accepting new patients

Locations

1677 Eagle Harbor Pkwy
Ste C
Orange Park, FL 32003
Phone (904) 278-5112

17 Old Kings Rd N
Ste D
Palm Coast, FL 32137
Phone (386) 445-4345

Interoperability endpoints

  • Direct secure messaging: eernst743521@direct.shands.ufl.edu

Organizations & group practices 3

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 1

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": "1215388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441238400000",
    "number": "1407019839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1677 EAGLE HARBOR PKWY",
            "address_2": "SUITE C",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320034802",
            "telephone_number": "904-278-5112",
            "fax_number": "904-278-5874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1677 EAGLE HARBOR PKWY",
            "address_2": "SUITE C",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320034802",
            "telephone_number": "904-278-5112",
            "fax_number": "904-278-5874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERNST",
        "first_name": "EMILY",
        "middle_name": "J",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-07",
        "last_updated": "2015-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO3484",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC006047",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fleming Island, FL

Sources for this page

Verify at the official NPI Registry.