Individual provider Active NPI

Justin D Hutto, ARNP

  • Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1508370230
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
9332486 Issued in FL
Practice address
2122 University Blvd S
Jacksonville, FL 32216-8937
Phone
(904) 398-5614
Fax
(904) 398-5617
NPI assigned
Nov 16, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 9332486 FL Primary

Addresses

Primary practice location

2122 University Blvd S
Jacksonville, FL 32216-8937

Mailing address

2122 University Blvd S
Jacksonville, FL 32216-8937
Phone (904) 398-5614

Other practice location 1

1555 Kingsley Ave Ste 201
Orange Park, FL 32073-9202
Phone (904) 398-5614

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
I20180525001407 FL Practitioner - Nurse Practitioner 4284999053 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9332486FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Florida Primary Care P L C CurrentSince Sep 1, 2019 Accepting new patients
Hni Medical Services of Florida, LLC Nurse Practitioner CurrentSince Jun 1, 2021 Accepting new patients
First Coast Infectious Disease Consultants LLC CurrentSince Apr 1, 2018 Accepting new patients
Georgia Infectious Disease Consultants Past Accepting new patients

Locations

900 N Robert Ave
Arcadia, FL 34266
Phone (863) 494-8426

13681 Doctors Way
Fort Myers, FL 33912
Phone (239) 343-1000

2122 University Blvd S
Jacksonville, FL 32216
Phone (904) 398-5614

1 Shircliff Way
Jacksonville, FL 32204
Phone (904) 332-0414

2035 Professional Center Dr
Orange Park, FL 32073
Phone (904) 272-0384

2035 Professional Center Dr
Ste B
Orange Park, FL 32073
Phone (904) 264-7132

1555 Kingsley Ave
Ste 201
Orange Park, FL 32073
Phone (904) 264-7132

7345 W Sand Lake Rd
Ste 206
Orlando, FL 32819
Phone (407) 248-8862

1700 Tamiami Trl
Sarasota, FL 34239
Phone (941) 917-8507

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/2841d-FUNyRbAEZPU2fkwLVgAHCA3S2l/
  • FHIR API: https://fhir4.healow.com/fhir/r4/IAJGCA

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1510790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1508370230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 UNIVERSITY BLVD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168937",
            "telephone_number": "904-398-5614",
            "fax_number": "904-398-5617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2122 UNIVERSITY BLVD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168937",
            "telephone_number": "904-398-5614",
            "fax_number": "904-398-5617"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1555 Kingsley Ave Ste 201",
            "address_purpose": "LOCATION",
            "city": "Orange Park",
            "state": "FL",
            "postal_code": "320739202",
            "country_code": "US",
            "telephone_number": "904-398-5614",
            "fax_number": "904-398-5617",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUTTO",
        "first_name": "JUSTIN",
        "middle_name": "D",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-16",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "9332486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.