Jabril Abdullah
Individual provider Active NPI Contractor · Jacksonville, FL
NPI 1497619175 · NPPES record last updated Dec 16, 2025
Key facts
- NPI
- 1497619175
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- Practice address
- 1274 State St W
Jacksonville, FL 32204-1046 - Phone
- (904) 537-2287
- NPI assigned
- Dec 16, 2025
- Sex
- Unspecified or another gender identity
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Undefined Non-Physician Type (Specify)
- Education
- Other, 2012
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1274 State St W B
Jacksonville, FL 32204-1046
129 Boyd St
Folkston, GA 31537-4937
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| House of Trap LLC | Contractor | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | Yes |
Addresses
Primary practice location
1274 State St W
Jacksonville, FL 32204-1046
Mailing address
129 Boyd St
Folkston, GA 31537-4937
Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 16, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.