Active NPI
Jennifer Moran, FNP-BC
- Primary Care Nurse Practitioner
- Jacksonville, FL
National Provider Identifier
1972929545
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- APRN11026287
- Practice address
- 2732 Trollie LN
Jacksonville, FL 32211-3833 - Phone
- (904) 289-1254
- Fax
- (904) 212-0036
- NPI assigned
- Mar 6, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | APRN11026287 | FL | Primary |
| Critical Care Medicine Nurse Practitioner | 363LC0200X | 2014007481 | MO | |
| Primary Care Nurse Practitioner | 363LP2300X | 2014007481 | MO | |
| Family Nurse Practitioner | 363LF0000X | 2014007481 | MO | |
| Registered Nurse | 163W00000X | 2000146301 | MO | |
| Registered Nurse | 163W00000X | 14-84822-031 | KS | |
| Primary Care Nurse Practitioner | 363LP2300X | 53-76854-031 | KS |
Addresses
Primary practice location
2732 Trollie LN
Jacksonville, FL 32211-3833
Mailing address
PO Box 600365
Jacksonville, FL 32260-0365
Phone (904) 289-1254
Other practice location 1
2789 Park St
Jacksonville, FL 32205-7607
Phone (904) 289-1254
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2013025793 | Other | ANCC | |
| 53-76854-031 | Other | KS | LICENSE |
| APRN11026287 | Other | FL | LICENSE |
| 2000146301 | Other | MO | LICENSE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14-84822-031 | KS | MD | Registered Nurse |
| 2000146301 | MO | MD | Registered Nurse |
| APRN11026287 | FL | MD | Primary Care Nurse Practitioner |
| 53-76854-031 | KS | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Caremax Clinic 711 LLC | Current | Accepting new patients |
Locations
2732 Trollie Ln
Jacksonville, FL 32211
Phone (904) 289-1254
2789 Park St
Jacksonville, FL 32205
Phone (904) 289-1254
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- Jacksonville, FL
- NPI 1609359249
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1394064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757030400000",
"number": "1972929545",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 600365",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322600365",
"telephone_number": "904-289-1254",
"fax_number": "904-212-0036"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2732 TROLLIE LN",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322113833",
"telephone_number": "904-289-1254",
"fax_number": "904-212-0036"
}
],
"practiceLocations": [
{
"address_1": "2789 Park St",
"address_purpose": "LOCATION",
"city": "Jacksonville",
"state": "FL",
"postal_code": "322057607",
"country_code": "US",
"telephone_number": "904-289-1254",
"fax_number": "904-212-0036",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MORAN",
"first_name": "JENNIFER",
"credential": "FNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-03-06",
"last_updated": "2025-09-05",
"certification_date": "2025-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "FL",
"license": "APRN11026287",
"primary": true
},
{
"code": "363LC0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Critical Care Medicine",
"state": "MO",
"license": "2014007481",
"primary": false
},
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "MO",
"license": "2014007481",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MO",
"license": "2014007481",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MO",
"license": "2000146301",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "KS",
"license": "14-84822-031",
"primary": false
},
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "KS",
"license": "53-76854-031",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANCC",
"identifier": "2013025793",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "53-76854-031",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "APRN11026287",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "2000146301",
"state": "MO"
}
],
"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 Sep 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.