Individual provider Active NPI

Jennifer Schultz Jolley, CCC-SLP

  • Speech-Language Pathologist
  • Jacksonville, FL
National Provider Identifier
1942723101
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA16254 Issued in FL
Practice address
800 Prudential Dr
Jacksonville, FL 32207-8202
Phone
(904) 202-9755
NPI assigned
Jul 19, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SZ8047 FL
Speech-Language Pathologist 235Z00000X SA16254
Speech-Language Pathologist 235Z00000X SA16254 FL Primary

Addresses

Primary practice location

800 Prudential Dr
Jacksonville, FL 32207-8202

Mailing address

800 Prudential Dr
Jacksonville, FL 32207-8202
Phone (954) 445-0216

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250212003696 FL Practitioner - Qualified Speech Language Pathologist 3375073836 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Family Practice Associates, LLCGroup PAC ID 8820003411, 50 clinicians

Practice addresses (Care Compare)

1731 University Blvd S
Jacksonville, FL 32216-8928
Phone (904) 725-0200

3627 University Blvd S
Jacksonville, FL 32216-4256

Hospital & facility affiliations

  • HCA Florida Memorial Hospital Hospital, Jacksonville, FL, CCN 100179

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SA16254FLMDSpeech-Language Pathologist
SZ8047FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Family Practice Associates, LLC CurrentSince Jan 25, 2025 Accepting new patients
Memorial Family Practice Associates LLC Past Accepting new patients

Locations

1731 University Blvd S
Jacksonville, FL 32216
Phone (904) 725-0200

3627 University Blvd S
Ste 210
Jacksonville, FL 32216
Phone (904) 399-5311

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Interoperability endpoints

  • Direct secure messaging: jennifer.jolley@hca5.eclinicaldirectplus.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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1500422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1942723101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 PRUDENTIAL DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078202",
            "telephone_number": "954-445-0216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 PRUDENTIAL DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078202",
            "telephone_number": "904-202-9755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOLLEY",
        "first_name": "JENNIFER",
        "middle_name": "SCHULTZ",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-19",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SZ8047",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": "SA16254",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA16254",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jan 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.