Individual provider Active NPI

Jenelle C Longo, APRN

  • Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1508241506
Registry record updated Sep 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN9413215 Issued in FL
Practice address
14534 Old Saint Augustine Rd Ste 3210
Jacksonville, FL 32258-2645
Phone
(904) 675-4000
Fax
(904) 675-4007
NPI assigned
Jul 21, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN9413215 FL Primary
Family Nurse Practitioner 363LF0000X F339731-1 NY

Addresses

Primary practice location

14534 Old Saint Augustine Rd Ste 3210
Jacksonville, FL 32258-2645

Mailing address

11945 San Jose Blvd Ste 300
Jacksonville, FL 32223-1627
Phone (904) 396-1725

Other practice location 1

5191 First Coast Tech Pkwy # 3
Jacksonville, FL 32224-0609
Phone (904) 675-4000

Other names 1

  • Jenelle C Vargulick Former name

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
I20160601000431 FL Practitioner - Nurse Practitioner 2668781865 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Florida Surgeons PAGroup PAC ID 2769381391, 336 clinicians

Practice addresses (Care Compare)

14534 Old Saint Augustine Rd
Suite 3210
Jacksonville, FL 32258-2645
Phone (904) 880-1260

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN9413215FLMDNurse Practitioner
F339731-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Florida Surgeons, PA CurrentSince May 28, 2025 Accepting new patients
North Florida Surgeons, PA CurrentSince May 28, 2025 Accepting new patients

Locations

36468 Emerald Coast Pkwy
Ste 1101
Destin, FL 32541
Phone (850) 290-2154

1340 S 18th St
Ste 104
Fernandina Beach, FL 32034
Phone (904) 277-3277

11945 San Jose Blvd
Ste 300
Jacksonville, FL 32223

14534 Old St Augustine Rd
Ste 3210
Jacksonville, FL 32258
Phone (904) 880-1260

5191 First Coast Tech Pkwy
Fl 3
Jacksonville, FL 32224
Phone (904) 222-3332

11945 San Jose Blvd
Ste 102
Jacksonville, FL 32223
Phone (904) 268-3937

Interoperability endpoints

  • Direct secure messaging: jlongo147057@direct.hss.edu
  • Direct secure messaging: jenelle.longo.1@9109.direct.athenahealth.com

Organizations & group practices 2

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 3

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": "1437436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788825600000",
    "number": "1508241506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11945 SAN JOSE BLVD STE 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322231627",
            "telephone_number": "904-396-1725",
            "fax_number": "904-396-4893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14534 OLD SAINT AUGUSTINE RD STE 3210",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322582645",
            "telephone_number": "904-675-4000",
            "fax_number": "904-675-4007"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5191 First Coast Tech Pkwy # 3",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322240609",
            "country_code": "US",
            "telephone_number": "904-675-4000",
            "fax_number": "904-675-4007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONGO",
        "first_name": "JENELLE",
        "middle_name": "C",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-21",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN9413215",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F339731-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENELLE",
            "last_name": "VARGULICK",
            "middle_name": "C",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.