Individual provider Active NPI

Kara Lynn Russell, ARNP

  • Family Nurse Practitioner
  • Jacksonville Beach, FL
National Provider Identifier
1740415843
Registry record updated May 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9212186 Issued in FL
Practice address
3200 3Rd St S
Suite 200
Jacksonville Beach, FL 32250-6096
Phone
(904) 249-6110
Fax
(904) 249-6119
NPI assigned
May 19, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP9212186 FL Primary

Addresses

Primary practice location

3200 3Rd St S
Suite 200
Jacksonville Beach, FL 32250-6096

Mailing address

3200 3Rd St S
Suite 200
Jacksonville Beach, FL 32250-6096
Phone (904) 249-6110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1242691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242691200000",
    "number": "1740415843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 3RD ST S",
            "address_2": "SUITE 200",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322506096",
            "telephone_number": "904-249-6110",
            "fax_number": "904-249-6119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 3RD ST S",
            "address_2": "SUITE 200",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322506096",
            "telephone_number": "904-249-6110",
            "fax_number": "904-249-6119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "KARA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-19",
        "last_updated": "2009-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9212186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.