Individual provider Active NPI

Tetyana Marshall

  • Family Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1609706217
Registry record updated Aug 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11049463 Issued in FL
Practice address
5150 Belfort Rd BLDG 400
Jacksonville, FL 32256-6026
Phone
(904) 580-4730
NPI assigned
May 23, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2026

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 11049463 FL Primary

Addresses

Primary practice location

5150 Belfort Rd BLDG 400
Jacksonville, FL 32256-6026

Mailing address

5150 Belfort Rd BLDG 400
Jacksonville, FL 32256-6026
Phone (904) 580-4730

Other names 1

  • Tetyana Portyanko Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
88197WVMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1779494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786665600000",
    "number": "1609706217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5150 BELFORT RD BLDG 400",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566026",
            "telephone_number": "904-580-4730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5150 BELFORT RD BLDG 400",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566026",
            "telephone_number": "904-580-4730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "TETYANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-05-23",
        "last_updated": "2026-08-14",
        "certification_date": "2026-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11049463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TETYANA",
            "last_name": "PORTYANKO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2026; 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.