Individual provider Active NPI

Jennifer Moran, FNP-BC

  • Primary Care Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1972929545
Registry record updated Sep 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
APRN11026287 Issued in FL
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

Updated by the provider on Sep 5, 2025

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
2013025793OtherANCC
53-76854-031OtherKSLICENSE
APRN11026287OtherFLLICENSE
2000146301OtherMOLICENSE

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

LicenseStateTypeSpecialty
14-84822-031KSMDRegistered Nurse
2000146301MOMDRegistered Nurse
APRN11026287FLMDPrimary Care Nurse Practitioner
53-76854-031KSMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Caremax Clinic 711 LLC CurrentSince Sep 8, 2025 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.

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.

Verify at the official NPI Registry.