Individual provider Active NPI

Amanda Wetzel, APRN

  • Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1710489182
Registry record updated Jul 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN9354769 Issued in FL
Practice address
2511 Saint Johns Bluff Rd S Ste 201
Jacksonville, FL 32246-2345
Phone
(904) 384-2240
Fax
(904) 486-2314
NPI assigned
Mar 1, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2026

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 APRN9354769 FL Primary

Addresses

Primary practice location

2511 Saint Johns Bluff Rd S Ste 201
Jacksonville, FL 32246-2345

Mailing address

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

Other identifiers 3

IdentifierTypeStateIssuer
9Z3NFOtherFLBCBS
111229400MedicaidFL
N4261OtherFLMEDICARE

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
I20200901001151 FL Practitioner - Nurse Practitioner 9436576782 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians

Practice addresses (Care Compare)

7751 Baymeadows Rd E
Suite H
Jacksonville, FL 32256-5836
Phone (904) 425-6963

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN9354769FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Physician Group LLC CurrentSince Aug 23, 2021 Accepting new patients
Millennium Physician Group LLC CurrentSince Aug 23, 2021 Accepting new patients

Locations

14540 Cortez Blvd
Ste 102
Brooksville, FL 34613
Phone (352) 596-7255

1132 S 14th St
Fernandina Beach, FL 32034
Phone (904) 277-4690

2675 Winkler Ave
Fl 2
Fort Myers, FL 33901
Phone (855) 979-5700

7751 Baymeadows Rd E
Ste G
Jacksonville, FL 32256
Phone (904) 420-6202

7751 Baymeadows Rd E
Ste H
Jacksonville, FL 32256
Phone (904) 425-6963

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

Interoperability endpoints

  • Direct secure messaging: amanda.mcquagge.1@4290.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 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": "1519862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782950400000",
    "number": "1710489182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 W MONROE ST STE 200",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322041177",
            "telephone_number": "904-384-2240",
            "fax_number": "904-486-2314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2511 SAINT JOHNS BLUFF RD S STE 201",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322462345",
            "telephone_number": "904-384-2240",
            "fax_number": "904-486-2314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WETZEL",
        "first_name": "AMANDA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-01",
        "last_updated": "2026-07-02",
        "certification_date": "2026-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN9354769",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "9Z3NF",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111229400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "N4261",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.