Individual provider Active NPI

Sheri Renee Dorner, APRN

  • Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1730427352
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN9212878 Issued in FL
Practice address
841 Prudential Dr Ste 280
Jacksonville, FL 32207-8350
Phone
(904) 202-8550
Fax
(904) 393-7808
NPI assigned
Jan 17, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X APRN9212878 FL
Nurse Practitioner 363L00000X APRN9212878 FL Primary

Addresses

Primary practice location

841 Prudential Dr Ste 280
Jacksonville, FL 32207-8350

Mailing address

PO Box 746645
Atlanta, GA 30374-6645
Phone (904) 202-2092

Other identifiers 2

IdentifierTypeStateIssuer
0082177-00MedicaidFL
003131493AMedicaidGA

Other names 1

  • Sheri Renee Faulkner-Myers 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
I20130226000397 FL Practitioner - Nurse Practitioner 0042465940 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN9212878FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Specialty Physicians Inc CurrentSince Aug 11, 2024 Accepting new patients
University of Florida Jacksonville Physicians, Inc. Current Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Jan 24, 2017 Accepting new patients
Baptist Specialty Physicians Inc CurrentSince Apr 2, 2018 Accepting new patients
University of Florida Jacksonville Physicians Inc CurrentSince Jan 24, 2017 Accepting new patients

Locations

1443 San Marco Blvd
Jacksonville, FL 32207
Phone (904) 633-4110

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

841 Prudential Dr
Ste 280
Jacksonville, FL 32207
Phone (904) 202-8290

836 Prudential Dr
Ste 802
Jacksonville, FL 32207
Phone (904) 202-8290

836 Prudential Dr
Ste 807
Jacksonville, FL 32207
Phone (904) 202-8290

2418 E Plaza Dr
Tallahassee, FL 32308
Phone (850) 629-4861

Interoperability endpoints

  • Direct secure messaging: sdorner30116@baptisthealthsystemjacksonville.direct-ci.com

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": "1358380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1730427352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746645",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746645",
            "telephone_number": "904-202-2092",
            "fax_number": "904-376-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "841 PRUDENTIAL DR STE 280",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078350",
            "telephone_number": "904-202-8550",
            "fax_number": "904-393-7808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORNER",
        "first_name": "SHERI",
        "middle_name": "RENEE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-17",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "APRN9212878",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN9212878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0082177-00",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003131493A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHERI",
            "last_name": "FAULKNER-MYERS",
            "middle_name": "RENEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.