Gwendolyn Ann Merritt, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

ARNP2012872 Issued in FL

Practice address

120 King St
Jacksonville, FL 32204-2410

Phone

(904) 253-2785

Fax

(904) 253-1961

NPI assigned

Nov 13, 2007

Last updated

Nov 25, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ms. Gwendolyn Riley Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1194912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416873600000",
    "number": "1548440076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 UNIVERSITY BLVD N",
            "address_2": "MC-75",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322119230",
            "telephone_number": "904-253-2062",
            "fax_number": "904-253-1942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 KING ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322042410",
            "telephone_number": "904-253-2785",
            "fax_number": "904-253-1961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRITT",
        "first_name": "GWENDOLYN",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-13",
        "last_updated": "2014-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP2012872",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0062940-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GWENDOLYN",
            "last_name": "RILEY",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ellen Merriman
• Patrick S. Merriman
• Merritt Care Psychiatry PL
• Merritt Speech & Learning, Inc.
• Beckie Cora Merritt
• Jessica Merritt, CRNA
• Lindsey Shae Merritt, DO
• Marquette Merritt
• Sheila D Merritt, O.D.
• Shelly Erin Merritt, LMT

• Family Nurse Practitioner in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2014; 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.