Individual provider Active NPI

Yvette Tshiupula, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1689463192
Registry record updated Nov 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11040137 Issued in FL
Practice address
1660 Prudential Dr Ste 410
Jacksonville, FL 32207-8197
Phone
(904) 376-3800
NPI assigned
May 1, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11040137 FL Primary
Psychiatric/Mental Health Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WP0808X RN232629 GA

Addresses

Primary practice location

1660 Prudential Dr Ste 410
Jacksonville, FL 32207-8197

Mailing address

1660 Prudential Dr Ste 410
Jacksonville, FL 32207-8197
Phone (904) 376-3800

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
I20251204001558 FL Practitioner - Nurse Practitioner 3375036619 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coastal Community Health Services IncGroup PAC ID 0345463683, 54 clinicians
Balanced Wellbeing LLCGroup PAC ID 5193021848, 228 clinicians
TBJ Behavioral Center LLCGroup PAC ID 4981789823, 15 clinicians

Practice addresses (Care Compare)

22385 Flora Parke Xing
Fernandina Beach, FL 32034-8000
Phone (904) 404-8641

3200 SW 34TH Ave
Suite 701
Ocala, FL 34474-8443
Phone (877) 779-2429

6300 Beach Blvd
Jacksonville, FL 32216-2708
Phone (904) 724-9202

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN232629GAMDPsychiatric/Mental Health Registered Nurse
11040137FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Behavioral Health, LLC Single Specialty CurrentSince May 4, 2025 Accepting new patients
Coastal Community Health Services, Inc. CurrentSince Nov 24, 2025 Accepting new patients
Balanced Wellbeing LLC Single Specialty CurrentSince Nov 24, 2025 Accepting new patients
Coastal Community Health Services, Inc. Single Specialty CurrentSince Nov 24, 2025 Accepting new patients
TBJ Behavioral Center LLC Single Specialty CurrentSince Dec 23, 2025 Accepting new patients

Locations

22385 Flora Parke Xing
Fernandina Beach, FL 32034
Phone (904) 404-8641

1660 Prudential Dr
Ste 410
Jacksonville, FL 32207

6300 Beach Blvd
Jacksonville, FL 32216
Phone (904) 724-9202

3200 SW 34th Ave
Ste 701
Ocala, FL 34474
Phone (354) 445-1200

106 Shoppers Way
Ste 101
Brunswick, GA 31525
Phone (912) 275-8208

1022 Miller Ln SW
Darien, GA 31305
Phone (912) 257-8028

Organizations & group practices 5

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": "1746057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764288000000",
    "number": "1689463192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1660 PRUDENTIAL DR STE 410",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078197",
            "telephone_number": "904-376-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1660 PRUDENTIAL DR STE 410",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078197",
            "telephone_number": "904-376-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSHIUPULA",
        "first_name": "YVETTE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-01",
        "last_updated": "2025-11-28",
        "certification_date": "2025-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11040137",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN232629",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.