Individual provider Active NPI

Rosalind Ann Heller-Slevin, ARNP

  • Adult Health Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1871509810
Registry record updated Nov 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
735882 Issued in FL
Practice address
12058 San Jose Blvd
Suite1003
Jacksonville, FL 32223-8666
Phone
(904) 880-6728
NPI assigned
Jul 31, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 735882 FL Primary

Addresses

Primary practice location

12058 San Jose Blvd
Suite1003
Jacksonville, FL 32223-8666

Mailing address

3762 N Ride Dr
Jacksonville, FL 32223-7493
Phone (904) 262-6753

Other identifiers 1

IdentifierTypeStateIssuer
303228100MedicaidFL

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
735882FLMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
First Coast Primary Care Inc Past Accepting new patients
Advanced Wound Systems LLC Past Accepting new patients
Apex House Call Doctors LLC Past Accepting new patients
Nautilus Health Care Group, LLC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258416000000",
    "number": "1871509810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3762 N RIDE DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322237493",
            "telephone_number": "904-262-6753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12058 SAN JOSE BLVD",
            "address_2": "SUITE1003",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322238666",
            "telephone_number": "904-880-6728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HELLER-SLEVIN",
        "first_name": "ROSALIND",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2009-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "735882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "303228100",
            "state": "FL"
        }
    ],
    "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 Nov 17, 2009; 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.