Individual provider Active NPI

Claire Solomon Basco, APRN

  • Pediatric Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1831725530
Registry record updated Mar 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
11006084 Issued in FL
Practice address
1631 Race Track Rd Ste 101
Jacksonville, FL 32259-3233
Phone
(904) 230-7977
NPI assigned
Mar 14, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 11006084 FL Primary

Addresses

Primary practice location

1631 Race Track Rd Ste 101
Jacksonville, FL 32259-3233

Mailing address

2178 Cavalry Blvd
Jacksonville, FL 32246-1407
Phone (904) 294-5097

Other practice location 1

9860 Beach Blvd
Jacksonville, FL 32246-4704
Phone (904) 642-9929

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11006084FLMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Associates of Julington Creek PastSince Mar 22, 2020 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JCFAAA

Organizations & group practices 1

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": "1584144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584144000000",
    "number": "1831725530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2178 CAVALRY BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322461407",
            "telephone_number": "904-294-5097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1631 RACE TRACK RD STE 101",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322593233",
            "telephone_number": "904-230-7977"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9860 Beach Blvd",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322464704",
            "country_code": "US",
            "telephone_number": "904-642-9929",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BASCO",
        "first_name": "CLAIRE",
        "middle_name": "SOLOMON",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-14",
        "last_updated": "2020-03-14",
        "certification_date": "2020-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "11006084",
            "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 Mar 14, 2020; 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.