Individual provider Active NPI

Marianne Fong NG, APRN

  • Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1679235618
Registry record updated Jul 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11015778 Issued in FL
Practice address
1485 Fouraker Rd Apt 8307
Jacksonville, FL 32221-6186
Phone
(813) 334-4190
NPI assigned
Oct 7, 2021
Last updated
Jul 6, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN11015778 FL Primary
Family Nurse Practitioner 363LF0000X APRN11015778 FL

Addresses

Primary practice location

1485 Fouraker Rd Apt 8307
Jacksonville, FL 32221-6186

Mailing address

1485 Fouraker Rd Apt 8307
Jacksonville, FL 32221-6186

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
I20220516000069 FL Practitioner - Nurse Practitioner 1759768633 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

915 W Monroe St
Suite 200
Jacksonville, FL 32204-1177
Phone (904) 384-2240

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
47.54 of 100Reported as apm
Quality
38.49
Promoting interoperability
0
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11015778FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North East Florida Endocrine and Diabetes Assoc PA CurrentSince Feb 6, 2026 Accepting new patients
Northeast Florida Endocrine and Diabetes Associates PA CurrentSince Feb 6, 2026 Accepting new patients

Locations

915 W Monroe St
Ste 200
Jacksonville, FL 32204

1375 Roberts Dr
Ste 206
Jax Bch, FL 32250
Phone (904) 247-1456

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1633564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783296000000",
    "number": "1679235618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1485 FOURAKER RD APT 8307",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322216186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1485 FOURAKER RD APT 8307",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322216186",
            "telephone_number": "813-334-4190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NG",
        "first_name": "MARIANNE",
        "middle_name": "FONG",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-07",
        "last_updated": "2026-07-06",
        "certification_date": "2026-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11015778",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11015778",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.