Organization Active NPI

Pam Rillstone, PHD, CNS, BC, CT, PLLC

  • Adult Psychiatric/Mental Health Clinical Nurse Specialist
  • Jacksonville, FL
National Provider Identifier
1740595271
Registry record updated Aug 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X
License
ARNP 1247222 Issued in FL
Legal business name
PAM RILLSTONE, PHD, CNS, BC, CT, PLLC
Practice address
6817 Southpoint Pkwy
Ste 304
Jacksonville, FL 32216-6282
Phone
(904) 296-3113
Fax
(904) 296-3144
NPI assigned
Aug 9, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2010

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

Authorized official

Name
Dr. Pam Rillstone, PHD, ARNP, CNS
Title
Manager
Phone
(904) 610-2761

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Clinical Nurse SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 364SP0809X ARNP 1247222 FL Primary

Addresses

Primary practice location

6817 Southpoint Pkwy
Ste 304
Jacksonville, FL 32216-6282

Mailing address

13801 Victoria Lakes Dr
Jacksonville, FL 32226-4898
Phone (904) 610-2761

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1281312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281312000000",
    "number": "1740595271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13801 VICTORIA LAKES DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322264898",
            "telephone_number": "904-610-2761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6817 SOUTHPOINT PKWY",
            "address_2": "STE 304",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322166282",
            "telephone_number": "904-296-3113",
            "fax_number": "904-296-3144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAM RILLSTONE, PHD, CNS, BC, CT, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-09",
        "last_updated": "2010-08-09",
        "status": "A",
        "authorized_official_last_name": "RILLSTONE",
        "authorized_official_first_name": "PAM",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "904-610-2761",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, ARNP, CNS"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "FL",
            "license": "ARNP 1247222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2010; 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.