Individual provider Active NPI

Molly Joan Hernandez, FNP

  • Family Nurse Practitioner
  • Crescent City, FL
National Provider Identifier
1609408160
Registry record updated Mar 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11006138 Issued in FL
Practice address
899 N Summit St
Crescent City, FL 32112-2109
Phone
(386) 698-1088
Fax
(386) 698-1099
NPI assigned
Feb 12, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11006138 FL Primary

Addresses

Primary practice location

899 N Summit St
Crescent City, FL 32112-2109

Mailing address

899 N Summit St
Crescent City, FL 32112-2109
Phone (386) 698-1088

Other practice location 1

301 Viking St
Palatka, FL 32177-3846
Phone (386) 937-6650 ext. 38632

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
I20210819000929 FL Practitioner - Nurse Practitioner 3577971951 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospital Physician Services of Florida PAGroup PAC ID 7012201965, 212 clinicians

Practice addresses (Care Compare)

611 Zeagler Dr
Palatka, FL 32177-3810
Phone (386) 328-5711

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11006138FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Putnam Physicians Group LLC CurrentSince Mar 7, 2021 Accepting new patients
Community Rural Health Inc CurrentSince Mar 7, 2021 Accepting new patients
Hospital Physician Services of Florida PA CurrentSince Aug 15, 2021 Accepting new patients

Locations

899 N Summit St
Crescent City, FL 32112
Phone (386) 689-1088

611 Zeagler Dr
Palatka, FL 32177
Phone (386) 326-8070

8383 N Davis Hwy
Pensacola, FL 32514
Phone (850) 494-3212

Organizations & group practices 3

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 1

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": "1581465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615161600000",
    "number": "1609408160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "899 N SUMMIT ST",
            "city": "CRESCENT CITY",
            "state": "FL",
            "postal_code": "321122109",
            "telephone_number": "386-698-1088",
            "fax_number": "386-698-1099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "899 N SUMMIT ST",
            "city": "CRESCENT CITY",
            "state": "FL",
            "postal_code": "321122109",
            "telephone_number": "386-698-1088",
            "fax_number": "386-698-1099"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 Viking St",
            "address_purpose": "LOCATION",
            "city": "Palatka",
            "state": "FL",
            "postal_code": "321773846",
            "country_code": "US",
            "telephone_number": "386-937-6650 x38632",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "MOLLY",
        "middle_name": "JOAN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-12",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11006138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crescent City, FL

Sources for this page

Verify at the official NPI Registry.