Individual provider Active NPI

Jessica Luckado Caveny, PA-C

  • Physician Assistant
  • Starke, FL
National Provider Identifier
1871054205
Registry record updated Jun 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9120022 Issued in FL
Practice address
14044 SE 48TH Ave
Starke, FL 32091-6849
Phone
(904) 263-5422
NPI assigned
Mar 28, 2019
Last updated
Jun 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9120022 FL Primary

Addresses

Primary practice location

14044 SE 48TH Ave
Starke, FL 32091-6849

Mailing address

1500 1St Ave N Unit 3
Birmingham, AL 35203-1866

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
I20250613001741 FL Practitioner - Physician Assistant 3274044631 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rural Urgent Care LLCGroup PAC ID 8820305600, 171 clinicians

Practice addresses (Care Compare)

1730 Pat Thomas Pkwy
Quincy, FL 32351-8681
Phone (850) 662-0041

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9120022FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rural Urgent Care LLC CurrentSince Jun 15, 2025 Accepting new patients
Rural Urgent Care LLC CurrentSince Jun 6, 2025 Accepting new patients
Rural Urgent Care LLC Current Accepting new patients
Rural Urgent Care LLC CurrentSince Jun 6, 2025 Accepting new patients

Locations

1500 1st Ave N
Unit 3
Birmingham, AL 35203
Phone (205) 545-5088

1730 Pat Thomas Pkwy
Quincy, FL 32351
Phone (850) 662-0041

14044 SE 48th Ave
Starke, FL 32091
Phone (904) 263-5422

Organizations & group practices 4

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": "1553731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1871054205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 1ST AVE N UNIT 3",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352031866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14044 SE 48TH AVE",
            "city": "STARKE",
            "state": "FL",
            "postal_code": "320916849",
            "telephone_number": "904-263-5422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVENY",
        "first_name": "JESSICA",
        "middle_name": "LUCKADO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-28",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9120022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Starke, FL

Sources for this page

Verify at the official NPI Registry.