Amber Jack, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APRN11017398 Issued in FL

Practice address

6619 N Wickham Rd
Melbourne, FL 32940-2006

Phone

(321) 259-9500

Fax

(321) 253-1777

NPI assigned

Mar 29, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Suntree Internal Medicine, Inc.Group PAC ID 1951378694, 16 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Viera Hospital Hospital, Melbourne, FL, CCN 100315

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Suntree Internal Medicine, LLC.

  • Internal Medicine Physician
  • Melbourne, FL
  • NPI 1700947884
  Medicare reassignment Care Compare group NPD
• Suntree Endocrinology

  • Internal Medicine Physician
  • Melbourne, FL
  • NPI 1679072375
  NPD
• Medical Associates of Brevard LLC

  • Multi-Specialty Clinic/Center
  • Melbourne, FL
  • NPI 1861400103
  NPD (past)

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

• Viera Hospital Inc

  • General Acute Care Hospital
  • Melbourne, FL
  • NPI 1730494816
  Care Compare affiliation

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

{
    "created_epoch": "1648512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748908800000",
    "number": "1992445951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6619 N WICKHAM RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329402006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6619 N WICKHAM RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329402006",
            "telephone_number": "321-259-9500",
            "fax_number": "321-253-1777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6156 Breslay Dr Ste 102",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329408727",
            "country_code": "US",
            "telephone_number": "321-259-9500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACK",
        "first_name": "AMBER",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-29",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11017398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Isma, DPM
• Steven Laurence Israel, M.D.
• Abdimomun Iuldashev, M.D.
• Andrea Izquierdo, DOM, LAC
• J Phyllis Brannen LCSW Cap
• Susan J Jacksland, OTR
• Audrey Lee Farson Jackson, APRN
• Jessica Jackson
• Tiye Jackson, PTA
• Valerie P. Jackson, MA

• Nurse Practitioner in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.