Individual provider Active NPI

Sharon Schwartz, R.N.

  • Acute Care Nurse Practitioner
  • Middleburg, FL
National Provider Identifier
1639557572
Registry record updated Jun 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
9169036 Issued in FL
Practice address
1658 St Vincents Way Ste 240
Middleburg, FL 32068
Phone
(904) 449-7288
Fax
(904) 203-2173
NPI assigned
May 12, 2015
Last updated
Jun 25, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 9169036 FL Primary

Addresses

Primary practice location

1658 St Vincents Way Ste 240
Middleburg, FL 32068

Mailing address

4205 Belfort Rd Ste 4015
Jacksonville, FL 32216-3623
Phone (904) 296-5691

Other identifiers 2

IdentifierTypeStateIssuer
015436100MedicaidFL
003166424AMedicaidGA

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
I20150914001147 FL Practitioner - Nurse Practitioner 4587971213 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9169036FLMDAcute Care Nurse Practitioner

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1431388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529884800000",
    "number": "1639557572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 BELFORT RD STE 4015",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163623",
            "telephone_number": "904-296-5691",
            "fax_number": "904-450-6401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1658 ST VINCENTS WAY STE 240",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "32068",
            "telephone_number": "904-449-7288",
            "fax_number": "904-203-2173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWARTZ",
        "first_name": "SHARON",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-12",
        "last_updated": "2018-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "9169036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015436100",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003166424A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middleburg, FL

Sources for this page

Verify at the official NPI Registry.