Individual provider Active NPI

Telisa Grant, APRN

  • Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1720494941
Registry record updated Aug 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN9215166 Issued in FL
Practice address
10257 Magnolia Ridge Dr
Jacksonville, FL 32210-4991
Phone
(904) 528-6357
NPI assigned
Jul 8, 2014
Last updated
Aug 4, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN9215166 FL
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X APRN9215166 FL Primary

Addresses

Primary practice location

10257 Magnolia Ridge Dr
Jacksonville, FL 32210-4991

Mailing address

10257 Magnolia Ridge Dr
Jacksonville, FL 32210-4991
Phone (904) 528-6357

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
I20190319001234 FL Practitioner - Nurse Practitioner 1355681982 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hni Medical Services of Florida, LLCGroup PAC ID 7517202112, 104 clinicians

Practice addresses (Care Compare)

4201 Belfort Rd
Jacksonville, FL 32216-1431
Phone (512) 730-3056

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN9215166FLMDRegistered Nurse
APRN9215166FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Intensive Care Experts Health Network LLC Multi-Specialty CurrentSince Sep 18, 2025 Accepting new patients
Intensive Care Experts Health Network LLC Multi-Specialty CurrentSince Sep 18, 2025 Accepting new patients
Hni Medical Services of Florida, LLC Multi-Specialty CurrentSince Mar 1, 2019 Accepting new patients

Locations

13755 Golf Club Pkwy
Fort Myers, FL 33919
Phone (239) 482-2848

701 N Federal Hwy
Ste 601
Hallandale Beach, FL 33009
Phone (954) 573-2195

1 Shircliff Way
Jacksonville, FL 32204
Phone (904) 332-0414

12645 Salina Dr
Jacksonville, FL 32246
Phone (904) 787-8150

4201 Belfort Rd
Jacksonville, FL 32216
Phone (904) 268-5561

9355 San Jose Blvd
Jacksonville, FL 32257
Phone (904) 738-0877

1670 St Vincents Way
Middleburg, FL 32068
Phone (904) 308-3960

4033 Beaver Ln
Pt Charlotte, FL 33952
Phone (941) 212-2748

Organizations & group practices 4

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1404777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785801600000",
    "number": "1720494941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10257 MAGNOLIA RIDGE DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322104991",
            "telephone_number": "904-528-6357",
            "fax_number": "646-337-1749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10257 MAGNOLIA RIDGE DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322104991",
            "telephone_number": "904-528-6357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "TELISA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-08",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9215166",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN9215166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.