1982297230 NPI number — MEREDITH KATHLEEN JONES DNP, APRN

Table of content: MEREDITH KATHLEEN JONES DNP, APRN (NPI 1982297230)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982297230 NPI number — MEREDITH KATHLEEN JONES DNP, APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JONES
Provider First Name:
MEREDITH
Provider Middle Name:
KATHLEEN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DNP, APRN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KELLY
Provider Other First Name:
MEREDITH
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1982297230
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/18/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1875 BEACHSIDE CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ATLANTIC BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32233-5954
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-668-3878
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
JACKSONVILLE CARDIOVASCULAR CENTER
Provider Second Line Business Practice Location Address:
6444 BEACH BLVD
Provider Business Practice Location Address City Name:
JACKSONVILLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32216
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
904-805-9600
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/18/2021

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  11008672 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 110297100 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".