Organization Active NPI

Bay Harbor Health and Wellness LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1790615813
Registry record updated May 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
BAY HARBOR HEALTH AND WELLNESS LLC
Practice address
12627 San Jose Blvd Ste 204
Jacksonville, FL 32223-8638
Phone
(423) 715-8037
NPI assigned
May 20, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2026

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

Authorized official

Name
Meredith Brainard, ARNP
Title
Sole Member
Phone
(423) 715-8037

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

12627 San Jose Blvd Ste 204
Jacksonville, FL 32223-8638

Mailing address

101 Paradise Valley Dr
Ponte Vedra, FL 32081-6123
Phone (423) 715-8037

National Provider Directory

National Provider Directory

Locations

12627 San Jose Blvd
Ste 204
Jacksonville, FL 32223
Phone (423) 715-8037

NPI Registry JSON

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

{
    "created_epoch": "1779235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779235200000",
    "number": "1790615813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 PARADISE VALLEY DR",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320816123",
            "telephone_number": "423-715-8037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12627 SAN JOSE BLVD STE 204",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322238638",
            "telephone_number": "423-715-8037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAY HARBOR HEALTH AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-05-20",
        "last_updated": "2026-05-20",
        "certification_date": "2026-05-12",
        "status": "A",
        "authorized_official_last_name": "BRAINARD",
        "authorized_official_first_name": "MEREDITH",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "423-715-8037",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "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 May 20, 2026; 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.