Individual provider Active NPI

Bethany Jean Bell

  • Family Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1699117408
Registry record updated May 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9277309 Issued in FL
Practice address
1824 King St
Suite 300
Jacksonville, FL 32204-4736
Phone
(904) 388-1820
Fax
(904) 388-1827
NPI assigned
Jul 22, 2013
Last updated
May 28, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP9277309 FL Primary

Addresses

Primary practice location

1824 King St
Suite 300
Jacksonville, FL 32204-4736

Mailing address

1824 King St
Suite 300
Jacksonville, FL 32204-4736
Phone (904) 388-1820

Other names 1

  • Bethany Jean Samuels Former name

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
I20130920000323 FL Practitioner - Nurse Practitioner 2961646518 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Vincent's Ambulatory Care IncGroup PAC ID 2860411188, 303 clinicians

Practice addresses (Care Compare)

1824 King St
Suite 300
Jacksonville, FL 32204-4736
Phone (904) 388-1820

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9277309FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincents Ambulatory Care Inc CurrentSince Aug 5, 2013 Accepting new patients
St Vincents Ambulatory Care Inc CurrentSince Aug 5, 2013 Accepting new patients

Locations

1824 King St
Ste 300
Jacksonville, FL 32204
Phone (904) 381-9393

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

Interoperability endpoints

  • Direct secure messaging: bethany.bell.1@8967.direct.athenahealth.com

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 6

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": "1374451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401235200000",
    "number": "1699117408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1824 KING ST",
            "address_2": "SUITE 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044736",
            "telephone_number": "904-388-1820",
            "fax_number": "904-388-1827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1824 KING ST",
            "address_2": "SUITE 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044736",
            "telephone_number": "904-388-1820",
            "fax_number": "904-388-1827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELL",
        "first_name": "BETHANY",
        "middle_name": "JEAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-22",
        "last_updated": "2014-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9277309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETHANY",
            "last_name": "SAMUELS",
            "middle_name": "JEAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.