Individual provider Active NPI

Tracie Claudice Rutledge, ARNP

  • Family Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1447524012
Registry record updated Feb 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9300116 Issued in FL
Practice address
1833 Boulevard
Ufjax - Total Care Clinic
Jacksonville, FL 32206-4382
Phone
(904) 383-1040
Fax
(904) 244-8952
NPI assigned
Feb 29, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2014

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 ARNP9300116 FL Primary

Addresses

Primary practice location

1833 Boulevard
Ufjax - Total Care Clinic
Jacksonville, FL 32206-4382

Mailing address

PO Box 44008
Ufjp - Provider Enrollment
Jacksonville, FL 32231-4008
Phone (904) 244-3199

Other identifiers 1

IdentifierTypeStateIssuer
004672800MedicaidFL

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
I20120518000310 FL Practitioner - Nurse Practitioner 6800784232 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Florida Jacksonville Physicians, Inc.Group PAC ID 9133025869, shared by 5 NPIs, 908 clinicians
Gateway Community Services IncGroup PAC ID 7618056649, 5 clinicians

Practice addresses (Care Compare)

1833 Boulevard Ave
Jacksonville, FL 32206-4394
Phone (904) 383-1040

555 Stockton St
Jacksonville, FL 32204-2534
Phone (904) 387-4661

761 Edgewood Ave N
Jacksonville, FL 32254-3013
Phone (904) 633-0500

Hospital & facility affiliations

  • Shands Jacksonville Hospital, Jacksonville, FL, CCN 100001

Merit-based Incentive Payment System (MIPS)

Final score
59.59 of 100Reported as apm
Quality
59.93
Promoting interoperability
0
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9300116FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians Inc Current Accepting new patients
University of Florida Jacksonville Physicians Inc CurrentSince Mar 1, 2014 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Jan 6, 2014 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Jan 6, 2014 Accepting new patients
Gateway Community Services, Inc. CurrentSince Nov 19, 2025 Accepting new patients
My Home Doctor, LLC Past Accepting new patients

Locations

1255 Lila St
Jacksonville, FL 32208
Phone (904) 244-5700

761 Edgewood Ave N
Jacksonville, FL 32254
Phone (904) 389-0041

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

1833 Boulevard
Jacksonville, FL 32206
Phone (904) 244-3289

555 Stockton St
Jacksonville, FL 32204
Phone (904) 387-4661

2133 Broadway Ave
Jacksonville, FL 32209
Phone (904) 361-5010

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1330473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391558400000",
    "number": "1447524012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44008",
            "address_2": "UFJP - PROVIDER ENROLLMENT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322314008",
            "telephone_number": "904-244-3199",
            "fax_number": "904-244-3425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1833 BOULEVARD",
            "address_2": "UFJAX - TOTAL CARE CLINIC",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322064382",
            "telephone_number": "904-383-1040",
            "fax_number": "904-244-8952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTLEDGE",
        "first_name": "TRACIE",
        "middle_name": "CLAUDICE",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-29",
        "last_updated": "2014-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9300116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004672800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.