Individual provider Active NPI

Jelysa Cain, APRN

  • Family Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1861069866
Registry record updated Jun 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11013564 Issued in FL
Practice address
9390 Lem Turner Rd
Jacksonville, FL 32208-2200
Phone
(904) 766-2992
Fax
(904) 766-2993
NPI assigned
Jun 8, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11013564 FL
Adult Health Nurse Practitioner 363LA2200X 11013564 FL
Primary Care Nurse Practitioner 363LP2300X 11013564 FL
Family Nurse Practitioner 363LF0000X 11013564 FL Primary

Addresses

Primary practice location

9390 Lem Turner Rd
Jacksonville, FL 32208-2200

Mailing address

9390 Lem Turner Rd
Jacksonville, FL 32208-2200
Phone (904) 766-2992

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210803002615 FL Practitioner - Nurse Practitioner 6406250158 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rogers Cain MD PAGroup PAC ID 2961712039, 2 clinicians

Practice addresses (Care Compare)

9390 Lem Turner Rd
Suite 1
Jacksonville, FL 32208-2200
Phone (904) 766-2992

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11013564FLMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rogers Cain MD PA CurrentSince Jul 23, 2021 Accepting new patients
Wells Surgical Services, LLC PastSince Jul 23, 2021 Accepting new patients

Locations

9390 Lem Turner Rd
Ste 1
Jacksonville, FL 32208
Phone (904) 766-2992

9390 Lem Turner Rd
Jacksonville, FL 32208
Phone (904) 766-2992

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1623110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1861069866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9390 LEM TURNER RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322082200",
            "telephone_number": "904-766-2992",
            "fax_number": "904-766-2993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9390 LEM TURNER RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322082200",
            "telephone_number": "904-766-2992",
            "fax_number": "904-766-2993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAIN",
        "first_name": "JELYSA",
        "name_prefix": "Dr.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-08",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11013564",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "11013564",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "11013564",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11013564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.