Gerry Surrency, PMHNP-BC, ARNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

ARNP3174792 Issued in FL

Practice address

1895 Kingsley Ave Ste 403
Orange Park, FL 32073-4453

Phone

(904) 300-4341

Fax

(904) 300-4341

NPI assigned

Apr 22, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Virgin Islands Agency for Restorative Care, Inc.

  • Mental Health Counselor
  • St Thomas, VI
  • NPI 1588319784
  NPD

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

{
    "created_epoch": "1398124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1457771016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1895 KINGSLEY AVE STE 403",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734453",
            "telephone_number": "904-300-4341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1895 KINGSLEY AVE STE 403",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734453",
            "telephone_number": "904-300-4341",
            "fax_number": "904-300-4341"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7765 S County Road 231",
            "address_purpose": "LOCATION",
            "city": "Lake Butler",
            "state": "FL",
            "postal_code": "320545721",
            "country_code": "US",
            "telephone_number": "386-496-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SURRENCY",
        "first_name": "GERRY",
        "name_prefix": "Mr.",
        "credential": "PMHNP-BC, ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-22",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN3174792",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "ARNP3174792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Summit Physical Therapy, PLLC
• Sunshine State Anesthesia Partners LLC
• Sunshine Vital Transport LLC
• Jaerine Roa Superales
• Surgcenter of Orange Park, LLC
• Susan I Murray PA
• Susan Salehi MD PA
• Lyudmyla Susla
• Melissa Marie Sutton, PA-C
• SV - Jupiter Properties Inc

• Psychiatric/Mental Health Nurse Practitioner in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.