Individual provider Active NPI

Nicole Marie Neidhart, ARNP, CNM

  • Women's Health Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1750490819
Registry record updated May 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
3317462 Issued in FL
Practice address
15537 Whispering Fir Dr
Jacksonville, FL 32218-1346
Phone
(904) 371-6724
Fax
(904) 371-6724
NPI assigned
Aug 30, 2006
Last updated
May 28, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 3317462 FL Primary
Advanced Practice Midwife 367A00000X 3317462 FL

Addresses

Primary practice location

15537 Whispering Fir Dr
Jacksonville, FL 32218-1346

Mailing address

15537 Whispering Fir Dr
Jacksonville, FL 32218-1346
Phone (904) 371-6724

Other names 1

  • Nicole Marie Thomasneidhart 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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070725000304 FL Practitioner - Certified Nurse Midwife (CNM) 2860593555 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
3317462FLMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Duval Vascular Center, LLC CurrentSince Jun 1, 2020 Accepting new patients
Vascular Anesthesia Associates PLLC PastSince Mar 1, 2020 Accepting new patients

Locations

915 W Monroe St
Ste 100
Jacksonville, FL 32204
Phone (904) 518-1398

3001 Palm Harbor Blvd
Ste A
Palm Harbor, FL 34683

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.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779926400000",
    "number": "1750490819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15537 WHISPERING FIR DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322181346",
            "telephone_number": "904-371-6724",
            "fax_number": "904-371-6724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15537 WHISPERING FIR DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322181346",
            "telephone_number": "904-371-6724",
            "fax_number": "904-371-6724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEIDHART",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "credential": "ARNP, CNM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "FL",
            "license": "3317462",
            "primary": true
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "FL",
            "license": "3317462",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "THOMASNEIDHART",
            "middle_name": "MARIE",
            "credential": "ARNP, CNM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.