Individual provider Active NPI

Jill Christine Wenzel, CRNA

  • Certified Registered Nurse Anesthetist
  • Jacksonville, FL
National Provider Identifier
1770545915
Registry record updated May 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
ARNP2774692 Issued in FL
Practice address
655 W 8TH St
Ufjp Anesthesiology
Jacksonville, FL 32209-6511
Phone
(904) 244-4195
Fax
(904) 244-4908
NPI assigned
Apr 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X ARNP2774692 FL Primary

Addresses

Primary practice location

655 W 8TH St
Ufjp Anesthesiology
Jacksonville, FL 32209-6511

Mailing address

PO Box 44008
Ufjp Provider Enrollment
Jacksonville, FL 32231-4008
Phone (904) 244-3199

Other identifiers 2

IdentifierTypeStateIssuer
3067378-00MedicaidFL
720686430AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050309000899 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 6901850213 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP2774692FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
North Florida Anesthesia Consultants Inc Nurse Anesthetist, Certified Registered CurrentSince Mar 22, 2014 Accepting new patients
University of Florida Jacksonville Physicians, Inc. Current Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Mar 11, 2010 Accepting new patients
University of Florida Jacksonville Physicians Inc CurrentSince Mar 11, 2010 Accepting new patients
North Florida Anesthesia Consultants, Inc. CurrentSince Mar 22, 2014 Accepting new patients
Jacksonville Anesthesia Corporation Inc Past Accepting new patients

Locations

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

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

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274832000000",
    "number": "1770545915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44008",
            "address_2": "UFJP PROVIDER ENROLLMENT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322314008",
            "telephone_number": "904-244-3199",
            "fax_number": "904-244-3425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 W 8TH ST",
            "address_2": "UFJP ANESTHESIOLOGY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096511",
            "telephone_number": "904-244-4195",
            "fax_number": "904-244-4908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENZEL",
        "first_name": "JILL",
        "middle_name": "CHRISTINE",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-04",
        "last_updated": "2010-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP2774692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3067378-00",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "720686430A",
            "state": "GA"
        }
    ],
    "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 May 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.