Clyde Russell Boswell, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN11012607 Issued in FL

Practice address

8705 Perimeter Park Blvd Ste 2
Jacksonville, FL 32216-6353

Phone

(904) 248-3910

NPI assigned

Jan 23, 2019

Last updated

Mar 16, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Clyde Russell Boswell Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 1, 2025 through Jul 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Solantic of Jacksonville, LLC

  dba CareSpot-Yulee

  • Urgent Care Clinic/Center
  • Yulee, FL
  • NPI 1902574635
  NPD (past)

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

{
    "created_epoch": "1548201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678924800000",
    "number": "1598229718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 14TH ST N",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322503662",
            "telephone_number": "615-830-6176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8705 PERIMETER PARK BLVD STE 2",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322166353",
            "telephone_number": "904-248-3910"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "999 Girl Scout Rd",
            "address_purpose": "LOCATION",
            "city": "Burns",
            "state": "TN",
            "postal_code": "370299065",
            "country_code": "US",
            "telephone_number": "615-913-8493",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOSWELL",
        "first_name": "CLYDE",
        "middle_name": "RUSSELL",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-23",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11012607",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "25373",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CLYDE",
            "last_name": "BOSWELL",
            "middle_name": "RUSSELL",
            "credential": "CLYDE BOSWELL",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Nile Bostic, RBT
• Boston & Boston Enterprise Home Care
• Brett Christopher Boston, RN
• Jill D Boston, MD
• Bruce B Boswell, DO
• Rachel Botella, ARNP
• Banyan Botkin
• Fady Magdy Shoukry Botrous, DO
• William K Bott, M.D.
• Dominique M Botta, AU.D

• 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 Mar 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.