Individual provider Active NPI

Carla A Schlenke, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Orange Park, FL
National Provider Identifier
1720101892
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN2010112 Issued in FL
Practice address
165 Wells Rd
Suite 404
Orange Park, FL 32073-3035
Phone
(904) 264-3111
Fax
(904) 264-3213
NPI assigned
Apr 6, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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 ARNP2010112 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN2010112 FL Primary

Addresses

Primary practice location

165 Wells Rd
Suite 404
Orange Park, FL 32073-3035

Mailing address

1543 Kingsley Ave Ste 14
Orange Park, FL 32073-4570
Phone (904) 264-6977

Other practice location 1

1543 Kingsley Ave Ste 14
Orange Park, FL 32073-4570
Phone (904) 264-6977

Other identifiers 3

IdentifierTypeStateIssuer
DD947UOtherFLMEDICARE
004580500MedicaidFL
APRN2010112OtherFLSTATE LICENSE

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
I20100623000769 FL Practitioner - Nurse Practitioner 7719018571 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
First Coast Psychiatric Services, P.a.Group PAC ID 9133441421, 7 clinicians

Practice addresses (Care Compare)

1543 Kingsley Ave
Suite 14
Orange Park, FL 32073-4570
Phone (904) 264-6977

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN2010112FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Family Practice Associates, LLC CurrentSince Aug 3, 2015 Accepting new patients
First Coast Psychiatric Services, P.a. CurrentSince Jun 15, 2018 Accepting new patients
Georgia Infectious Disease Consultants Past Accepting new patients

Locations

1731 University Blvd S
Jacksonville, FL 32216
Phone (904) 725-0200

1543 Kingsley Ave
Ste 14
Orange Park, FL 32073
Phone (904) 264-6977

2001 Kingsley Ave
Orange Park, FL 32073
Phone (904) 215-7015

Organizations & group practices 3

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": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1720101892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1543 KINGSLEY AVE STE 14",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734570",
            "telephone_number": "904-264-6977",
            "fax_number": "904-269-0870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 WELLS RD",
            "address_2": "SUITE 404",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320733035",
            "telephone_number": "904-264-3111",
            "fax_number": "904-264-3213"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1543 Kingsley Ave Ste 14",
            "address_purpose": "LOCATION",
            "city": "Orange Park",
            "state": "FL",
            "postal_code": "320734570",
            "country_code": "US",
            "telephone_number": "904-264-6977",
            "fax_number": "904-269-0870",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHLENKE",
        "first_name": "CARLA",
        "middle_name": "A",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-06",
        "last_updated": "2023-03-07",
        "certification_date": "2022-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP2010112",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN2010112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "DD947U",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004580500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "APRN2010112",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

Verify at the official NPI Registry.