Individual provider Active NPI

Jillian A Nelson, M.D.

  • Developmental - Behavioral Pediatrics Physician
  • Lakeland, FL
National Provider Identifier
1912386434
Registry record updated Aug 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
License
ME157652 Issued in FL
Practice address
5120 S Florida Ave Ste 328
Lakeland, FL 33813-2628
Phone
(863) 395-1571
NPI assigned
May 29, 2015
Last updated
Aug 17, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME157652 FL
Developmental - Behavioral Pediatrics Physician 2080P0006X ME157652 FL Primary

Addresses

Primary practice location

5120 S Florida Ave Ste 328
Lakeland, FL 33813-2628

Mailing address

5120 S Florida Ave Ste 328
Lakeland, FL 33813-2628
Phone (863) 395-1571

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220926002617 FL Practitioner - Pediatric Medicine 5799011672 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME157652FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc Pediatrics CurrentSince Sep 12, 2022 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Sep 12, 2022 Accepting new patients

Locations

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

615 E Princeton St
Ste 300
Orlando, FL 32803
Phone (407) 228-4774

Interoperability endpoints

  • Direct secure messaging: jnelson862874@adventhealth.direct-ci.com

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, 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": "1432857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786924800000",
    "number": "1912386434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5120 S FLORIDA AVE STE 328",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132628",
            "telephone_number": "863-395-1571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5120 S FLORIDA AVE STE 328",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132628",
            "telephone_number": "863-395-1571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "JILLIAN",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-29",
        "last_updated": "2026-08-17",
        "certification_date": "2026-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME157652",
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "FL",
            "license": "ME157652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.