Individual provider Active NPI

Marjorie Marie Donnelly, ARNP

  • Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1639596125
Registry record updated Aug 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP9175372 Issued in FL
Practice address
836 Prudential Dr Ste 1400
Jacksonville, FL 32207-8340
Phone
(904) 388-6518
Fax
(904) 384-1005
NPI assigned
Mar 24, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2025

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 ARNP9175372 FL Primary

Addresses

Primary practice location

836 Prudential Dr Ste 1400
Jacksonville, FL 32207-8340

Mailing address

PO Box 746647
Atlanta, GA 30374-6647
Phone (904) 202-2092

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
I20140416000028 FL Practitioner - Nurse Practitioner 0042442519 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lyerly Baptist IncGroup PAC ID 9830112226, 72 clinicians

Practice addresses (Care Compare)

1370 13TH Ave S
Jacksonville, FL 32250-3206
Phone (904) 388-6518

Hospital & facility affiliations

  • Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088

Merit-based Incentive Payment System (MIPS)

Final score
80.78 of 100Reported as group
Quality
65.03
Promoting interoperability
100
Improvement activities
40
Cost
70.91

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lyerly Baptist Inc Nurse Practitioner CurrentSince Mar 31, 2014 Accepting new patients
Baptist Neurology Inc Past Accepting new patients
Lyerly Baptist Inc PastSince Jun 1, 2025 Accepting new patients

Locations

800 Prudential Dr
Ste 1100
Jacksonville, FL 32207
Phone (904) 338-6518

836 Prudential Dr
Ste 1400
Jacksonville, FL 32207
Phone (904) 396-0000

800 Prudential Dr
Fl 11
Jacksonville, FL 32207
Phone (904) 202-4765

1370 13th Ave S
Ste 215
Jax Bch, FL 32250
Phone (904) 249-1041

Interoperability endpoints

  • Direct secure messaging: mdonnelly24953@baptisthealthsystemjacksonville.direct-ci.com

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": "1395619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1639596125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746647",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746647",
            "telephone_number": "904-202-2092",
            "fax_number": "904-376-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 PRUDENTIAL DR STE 1400",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078340",
            "telephone_number": "904-388-6518",
            "fax_number": "904-384-1005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONNELLY",
        "first_name": "MARJORIE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-24",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9175372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.