Individual provider Active NPI

Jauvana Hall-Wills

  • Nurse Practitioner
  • Hollywood, FL
National Provider Identifier
1588312599
Registry record updated Mar 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11017066 Issued in FL
Practice address
1150 N 35TH Ave Ste 300
Hollywood, FL 33021-5428
Phone
(954) 265-1490
NPI assigned
Mar 17, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2022

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 11017066 FL Primary

Addresses

Primary practice location

1150 N 35TH Ave Ste 300
Hollywood, FL 33021-5428

Mailing address

1150 N 35TH Ave Ste 300
Hollywood, FL 33021-5428

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
I20220803002555 FL Practitioner - Nurse Practitioner 9032591359 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Broward Hospital DistrictGroup PAC ID 8123927373, 659 clinicians

Practice addresses (Care Compare)

1150 N 35TH Ave
Suite 300
Hollywood, FL 33021-5428
Phone (954) 985-1490

3501 Johnson St
Hollywood, FL 33021-5421
Phone (954) 265-9976

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11017066FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Broward Hospital District CurrentSince May 1, 2022 Accepting new patients
South Broward Hospital District CurrentSince May 1, 2022 Accepting new patients
South Broward Hospital District Current Accepting new patients
South Broward Hospital District Past Accepting new patients

Locations

1150 N 35th Ave
Ste 300
Hollywood, FL 33021
Phone (954) 265-1490

2900 Corporate Way
#D
Miramar, FL 33025
Phone (954) 276-5581

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.

Hospital & facility affiliations 2

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": "1647475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647475200000",
    "number": "1588312599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 N 35TH AVE STE 300",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330215428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 N 35TH AVE STE 300",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330215428",
            "telephone_number": "954-265-1490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL-WILLS",
        "first_name": "JAUVANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-17",
        "last_updated": "2022-03-17",
        "certification_date": "2022-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11017066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.