Individual provider Active NPI

Carrie Ann Santos, ARNP

  • Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1730554494
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
9277959 Issued in FL
Practice address
1824 King St Ste 300
Jacksonville, FL 32204-4736
Phone
(904) 388-1820
Fax
(904) 388-1827
NPI assigned
Dec 7, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X ARNP9277959 FL
Nurse Practitioner 363L00000X 9277959 FL Primary

Addresses

Primary practice location

1824 King St Ste 300
Jacksonville, FL 32204-4736

Mailing address

4205 Belfort Rd Ste 4015
Jacksonville, FL 32216-3623
Phone (904) 450-6004

Other identifiers 1

IdentifierTypeStateIssuer
16391200MedicaidFL

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
I20160226000530 FL Practitioner - Nurse Practitioner 8325340490 Reassigns benefits to 3 organizations

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
9277959FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hni Hospital Services of Florida, LLC Nurse Practitioner CurrentSince Jan 1, 2025 Accepting new patients
Hni Medical Services of Florida, LLC Nurse Practitioner CurrentSince Sep 23, 2019 Accepting new patients
St Vincents Ambulatory Care Inc CurrentSince Oct 1, 2017 Accepting new patients
St Vincents Ambulatory Care Inc CurrentSince Oct 1, 2017 Accepting new patients
Bagnoli and Salah Partnership PastSince Dec 14, 2015 Accepting new patients

Locations

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

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

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

2 Shircliff Way
Ste 300
Jacksonville, FL 32204
Phone (904) 308-7959

2 Shircliff Way
Ste 400
Jacksonville, FL 32204
Phone (904) 308-4000

4901 Richard St
Jacksonville, FL 32207
Phone (904) 425-0500

4205 Belfort Rd
Ste 2069
Jacksonville, FL 32216
Phone (904) 296-0278

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

615 N Bonita Ave
Panama City, FL 32401
Phone (850) 747-2020

7500 Rialto Blvd
Ste 1-140
Austin, TX 78735

Interoperability endpoints

  • Direct secure messaging: carrie.santos.1@8967.direct.athenahealth.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.

Hospital & facility affiliations 4

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": "1449446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1730554494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 BELFORT RD STE 4015",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163623",
            "telephone_number": "904-450-6004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1824 KING ST STE 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044736",
            "telephone_number": "904-388-1820",
            "fax_number": "904-388-1827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTOS",
        "first_name": "CARRIE",
        "middle_name": "ANN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-07",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "ARNP9277959",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "9277959",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "16391200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.