Individual provider Active NPI

Marjorie Matheny, FNP-C

  • Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1679110316
Registry record updated Sep 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11002222 Issued in FL
Practice address
7011 A C Skinner Pkwy Ste 160
Jacksonville, FL 32256-6953
Phone
(904) 493-3333
Fax
(904) 493-2222
NPI assigned
Dec 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2020

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 APRN11002222 FL Primary

Addresses

Primary practice location

7011 A C Skinner Pkwy Ste 160
Jacksonville, FL 32256-6953

Mailing address

3241 Hidden Meadows CT
Green CV SPGS, FL 32043-7051
Phone (904) 616-6021

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200205000164 FL Practitioner - Nurse Practitioner 2860828142 Reassigns benefits to 1 organization
I20220504001529 GA Practitioner - Nurse Practitioner 2860828142

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12 Cadillac Dr
Suite 300
Brentwood, TN 37027-5272

PO Box
Jacksonville, FL 32255

Merit-based Incentive Payment System (MIPS)

Final score
96.46 of 100Reported as group
Quality
91.35
Promoting interoperability
99
Improvement activities
40
Cost
81

Merit-based Incentive Payment System (MIPS)

Final score
79.1 of 100Reported as group
Quality
35.98
Promoting interoperability
100
Improvement activities
40
Cost
61.02

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11002222FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiac Vision LLC CurrentSince Apr 29, 2024 Accepting new patients
Clearwater Cardiovascular and Interventional Consultants MD PA Past Accepting new patients

Locations

6817 Southpoint Pkwy
Ste 203
Jacksonville, FL 32216
Phone (904) 256-9202

7807 Baymeadows Rd E
Ste 209
Jacksonville, FL 32256
Phone (904) 231-1204

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1575244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600646400000",
    "number": "1679110316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3241 HIDDEN MEADOWS CT",
            "city": "GREEN CV SPGS",
            "state": "FL",
            "postal_code": "320437051",
            "telephone_number": "904-616-6021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7011 A C SKINNER PKWY STE 160",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566953",
            "telephone_number": "904-493-3333",
            "fax_number": "904-493-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHENY",
        "first_name": "MARJORIE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-02",
        "last_updated": "2020-09-21",
        "certification_date": "2020-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11002222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.