Individual provider Active NPI

Kimberly Jill Grant, APRN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1902428568
Registry record updated Jun 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN11007366 Issued in FL
Practice address
2055 Reyko Rd Ste 100
Jacksonville, FL 32207-2828
Phone
(904) 648-8200
Fax
(904) 253-3270
NPI assigned
May 17, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11007366 FL Primary

Addresses

Primary practice location

2055 Reyko Rd Ste 100
Jacksonville, FL 32207-2828

Mailing address

2055 Reyko Rd Ste 100
Jacksonville, FL 32207-2828
Phone (904) 648-8200

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
I20210129000897 FL Practitioner - Nurse Practitioner 1557775749 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Harmony United Florida, LLCGroup PAC ID 9638306673, 86 clinicians

Practice addresses (Care Compare)

3235 SW 34TH St
Ocala, FL 34474-7501
Phone (352) 431-3940

Merit-based Incentive Payment System (MIPS)

Final score
89.95 of 100Reported as group
Quality
84.69
Promoting interoperability
100
Improvement activities
40
Cost
74.91

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2020010462FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
TBJ Behavioral Center LLC CurrentSince Mar 31, 2022 Accepting new patients
Southern Baptist Hospital of Florida Inc Past Accepting new patients
Southern Baptist Hospital PastSince Aug 5, 2022 Accepting new patients

Locations

6300 Beach Blvd
Jacksonville, FL 32216
Phone (904) 724-9202

Interoperability endpoints

  • Direct secure messaging: kgrant123681@baptisthealthsystemjacksonville.direct-ci.com

Organizations & group practices 5

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": "1589673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781049600000",
    "number": "1902428568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 REYKO RD STE 100",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322072828",
            "telephone_number": "904-648-8200",
            "fax_number": "904-253-3270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 REYKO RD STE 100",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322072828",
            "telephone_number": "904-648-8200",
            "fax_number": "904-253-3270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "KIMBERLY",
        "middle_name": "JILL",
        "credential": "APRN, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-17",
        "last_updated": "2026-06-10",
        "certification_date": "2026-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11007366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.