Individual provider Active NPI

Natalie Johnson

  • Psychiatric/Mental Health Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1730973470
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11038746 Issued in FL
Practice address
800 Prudential Dr
Jacksonville, FL 32207-8211
Phone
(718) 915-2122
NPI assigned
Apr 8, 2025
Last updated
Apr 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11038746 FL Primary

Addresses

Primary practice location

800 Prudential Dr
Jacksonville, FL 32207-8211

Mailing address

10175 Powell Creek CT
Jacksonville, FL 32222-2572
Phone (718) 915-2122

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
I20250603001032 FL Practitioner - Nurse Practitioner 0446769376 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
My Choice Operating Company LLCGroup PAC ID 3779991542, 60 clinicians

Practice addresses (Care Compare)

4655 Salisbury Rd
Suite 220
Jacksonville, FL 32256-0959
Phone (904) 570-9404

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11038746FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
My Choice Operating Company LLC Single Specialty CurrentSince May 12, 2025 Accepting new patients
Mobile Medical Operating Company LLC Single Specialty CurrentSince May 12, 2025 Accepting new patients

Locations

4655 Salisbury Rd
Ste 110
Jacksonville, FL 32256
Phone (904) 570-9404

4655 Salisbury Rd
Ste 220
Jacksonville, FL 32256
Phone (904) 570-9404

1840 SE Port St Lucie Blvd
Ste 1840
Port St Lucie, FL 34952
Phone (772) 221-7620

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": "1744070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1730973470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10175 POWELL CREEK CT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322222572",
            "telephone_number": "718-915-2122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 PRUDENTIAL DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078211",
            "telephone_number": "718-915-2122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "NATALIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-08",
        "last_updated": "2025-04-08",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11038746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.