Individual provider Active NPI

James Luel Poole, APRN

  • Nurse Practitioner
  • Archer, FL
National Provider Identifier
1780242388
Registry record updated Nov 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11002563 Issued in FL
Practice address
16939 SW 134TH Ave
Archer, FL 32618-5413
Phone
(352) 265-2550
Fax
(352) 627-4785
NPI assigned
May 30, 2019
Last updated
Nov 12, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11002563 FL
Nurse Practitioner 363L00000X APRN11002563 FL Primary

Addresses

Primary practice location

16939 SW 134TH Ave
Archer, FL 32618-5413

Mailing address

PO Box 100383
Gainesville, FL 32610-0383
Phone (352) 392-4541

Other practice location 1

1200 NE 55th Blvd
Gainesville, FL 32641-2783
Phone (352) 375-8484

Other practice location 2

1600 SW Archer Rd
Gainesville, FL 32610-2783
Phone (352) 392-4541

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210811000609 FL Practitioner - Nurse Practitioner 5597169615 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
47.54 of 100Reported as apm
Quality
38.49
Promoting interoperability
0
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11002563FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc CurrentSince Sep 6, 2021 Accepting new patients
University of Florida College of Nursing Faculty Practice Associati Psychiatric/Mental Health CurrentSince Nov 16, 2021 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Sep 6, 2021 Accepting new patients

Locations

16939 SW 134th Ave
Archer, FL 32618
Phone (352) 265-2550

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

Organizations & group practices 3

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": "1559174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636675200000",
    "number": "1780242388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100383",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100383",
            "telephone_number": "352-392-4541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16939 SW 134TH AVE",
            "city": "ARCHER",
            "state": "FL",
            "postal_code": "326185413",
            "telephone_number": "352-265-2550",
            "fax_number": "352-627-4785"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 NE 55th Blvd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326412783",
            "country_code": "US",
            "telephone_number": "352-375-8484",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1600 SW Archer Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326102783",
            "country_code": "US",
            "telephone_number": "352-392-4541",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POOLE",
        "first_name": "JAMES",
        "middle_name": "LUEL",
        "name_prefix": "Dr.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-30",
        "last_updated": "2021-11-12",
        "certification_date": "2021-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11002563",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11002563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Archer, FL

Sources for this page

Verify at the official NPI Registry.