Individual provider Active NPI

Tara Lynn Swanton

  • Family Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1982147963
Registry record updated Feb 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9238706 Issued in FL
Practice address
3901 University Blvd S
Suite 221
Jacksonville, FL 32216-4312
Phone
(904) 423-0010
Fax
(904) 423-0010
NPI assigned
Nov 23, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP9238706 FL Primary

Addresses

Primary practice location

3901 University Blvd S
Suite 221
Jacksonville, FL 32216-4312

Mailing address

4641 Clyde Morris Blvd
Unit 201
Port Orange, FL 32129-6002
Phone (386) 322-6340

Other names 1

  • Tara Lynn Hopkins Former name

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
I20170523000438 FL Practitioner - Nurse Practitioner 1759658735 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Renal Care Consultants PLGroup PAC ID 0941378731, 2 clinicians

Practice addresses (Care Compare)

4641 S Clyde Morris Blvd
Suite 201
Port Orange, FL 32129-6002
Phone (386) 322-6340

Hospital & facility affiliations

  • Adventhealth Daytona Beach Hospital, Daytona Beach, FL, CCN 100068
  • Adventhealth New Smyrna Beach Hospital, New Smyrna Beach, FL, CCN 100014

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9238706FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Integrative Healthcare Inc CurrentSince Jan 14, 2018 Accepting new patients
Coastal Integrative Healthcare Inc CurrentSince Jan 14, 2018 Accepting new patients
Renal Care Consultants PL CurrentSince Jul 16, 2019 Accepting new patients

Locations

315 N Ridgewood Ave
Edgewater, FL 32132
Phone (386) 427-8403

145 Cypress Point Pkwy
Ste 207
Palm Coast, FL 32164
Phone (386) 225-4700

4641 Clyde Morris Blvd
Unit 201
Port Orange, FL 32129
Phone (386) 322-6340

Organizations & group practices 3

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 3

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": "1479859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549238400000",
    "number": "1982147963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4641 CLYDE MORRIS BLVD",
            "address_2": "UNIT 201",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321296002",
            "telephone_number": "386-322-6340",
            "fax_number": "386-322-6212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 UNIVERSITY BLVD S",
            "address_2": "SUITE 221",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164312",
            "telephone_number": "904-423-0010",
            "fax_number": "904-423-0010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWANTON",
        "first_name": "TARA",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-23",
        "last_updated": "2019-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9238706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "HOPKINS",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.