NPIMap

Organization Active NPI

Artistic Psychiatric Associates LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1407320690
Registry record updated Oct 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
ARTISTIC PSYCHIATRIC ASSOCIATES LLC
Practice address
9889 Gate Pkwy N Ste 305
Jacksonville, FL 32246-9230
Phone
(904) 725-6463
Fax
(904) 329-2349
NPI assigned
Jan 22, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2023

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

Authorized official

Name
James TullyNPI 1053933903
Title
Owner
Phone
(904) 725-6463

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

9889 Gate Pkwy N Ste 305
Jacksonville, FL 32246-9230

Mailing address

9889 Gate Pkwy N Ste 305
Jacksonville, FL 32246-9230
Phone (904) 725-6463

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190205001695 FL Part B Supplier - Clinic/Group Practice 6608114335 Receives reassigned benefits from 8 practitioners
Practice locations: Jacksonville, FL

National Provider Directory

National Provider Directory

Locations

9550 Regency Square Blvd
Ste 903
Jacksonville, FL 32225
Phone (561) 523-9392

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1548115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696464000000",
    "number": "1407320690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9889 GATE PKWY N STE 305",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322469230",
            "telephone_number": "904-725-6463",
            "fax_number": "904-329-2349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9889 GATE PKWY N STE 305",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322469230",
            "telephone_number": "904-725-6463",
            "fax_number": "904-329-2349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARTISTIC PSYCHIATRIC ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-22",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A",
        "authorized_official_last_name": "TULLY",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-725-6463"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.