JOHANNA MERCEDEZ RUSSELL (NPI# 1205308640) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205308640 |
| Entity Type | Individual |
| Full Name | JOHANNA MERCEDEZ RUSSELL |
| Practice Address |
1918 Blanding Blvd Jacksonville FL 32210-3202 |
| Mailing Address |
12171 Sw 268th St Homestead FL 33032-8001 |
| Practice Telephone | 9043896954 |
| Mailing Telephone | 3052780200 |
| Enumeration Date | 2018-12-26 |
| Last Update Date | 2019-05-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | 9309493 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
APRN11001221 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
11001221 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 12526 Wages Way E, Jacksonville, FL 322188060 | 9046252644 |
| Street Address |
1918 BLANDING BLVD |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32210-3202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811054901 | Osvaldo Aviles-ribot | General Practice | 1918 Blanding Blvd, Jacksonville, FL 32210-3202 | 2007-01-02 |
| 1093270423 | Joel Anibal Marmolejos Nunez | General Practice | 1918 Blanding Blvd, Jacksonville, FL 32210-3202 | 2019-02-11 |
| 1164965174 | Tashenna Harris | Nurse Practitioner | 1918 Blanding Blvd, Jacksonville, FL 32210-3202 | 2016-11-22 |
| 1336545375 | Michelle A. Joseph | General Practice | 1918 Blanding Blvd, Jacksonville, FL 32210-3202 | 2014-11-18 |
| 1497003222 | American Care of North Florida, Inc | Internal Medicine | 1918 Blanding Blvd, Suite A, Jacksonville, FL 32210-3202 | 2012-08-28 |
| 1053679787 | American Care of North Florida, Inc | Internal Medicine | 1918 Blanding Blvd, Jacksonville, FL 32210-3202 | 2012-05-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326604729 | Finding Balance Counseling, LLC | Counselor | 4705 Palmer Ave, Jacksonville, FL 32210 | 2019-05-13 |
| 1609349620 | Jennifer Lash | Counselor | 4705 Palmer Avenue, Jacksonville, FL 32210 | 2019-01-03 |
| 1588147854 | Alan Craig Ashkinazy | Chiropractor | 5233 Ricker Rd Ste 102, Jacksonville, FL 32210 | 2018-09-12 |
| 1841781671 | Amanda Rodriguez-medina | Chiropractor | 6640 103rd St, Jacksonville, FL 32210 | 2018-05-29 |
| 1518457357 | Vicki Teal | Nurse Practitioner | 6488 103rd Street, Suite A, Jacksonville, FL 32210 | 2018-05-17 |
| 1811412539 | River City Companionship LLC | Clinic/Center | 7857 Delaroche Drive, Jacksonville, FL 32210 | 2017-08-03 |
| 1306366216 | Always Straight From The Heart | Homemaker | 6511 Betsy Court, Jacksonville, FL 32210 | 2017-06-21 |
| 1720538556 | Total Renal Care Inc | Clinic/Center | 5276 Blanding Blvd Ste 26, Jacksonville, FL 32210 | 2016-10-05 |
| 1700333978 | Recovery Counseling and More Inc | Clinic/Center | 4570 Saint Johns Ave, Ste B, Jacksonville, FL 32210 | 2016-09-06 |
| 1831645662 | Drucilla Young | Nurse's Aide | 1700 Blanding Blvd. 68n, Jacksonville, FL 32210 | 2016-08-31 |
| Find all providers in zip 32210 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023615440 | Bridget Mary Rossi | Nurse Practitioner | 1536 Alford Street, Unit 5, Jacksonville, FL 32207-3220 | 2020-10-08 |
| 1972119535 | Dennis Carmelo Cadiz Serfino | Nurse Practitioner | 1960 Willesdon Dr E, Jacksonville, FL 32246-0694 | 2020-09-18 |
| 1497368757 | Arthur C Ricker Jr. | Nurse Practitioner | 501 E Bay St Fl 32202, Jacksonville, FL 32202-2927 | 2020-08-26 |
| 1851851554 | Veronica H Bartley | Nurse Practitioner | 15319 Spotted Stallion Trl, Jacksonville, FL 32234-2397 | 2019-03-20 |
| 1366947475 | Tikilia Denise Scott | Nurse Practitioner | 3599 University Blvd S Ste 400, Jacksonville, FL 32216-4232 | 2018-03-29 |
| 1376065417 | Geraldine M Obi | Nurse Practitioner | 3599 University Blvd S Ste 1600, Jacksonville, FL 32216-7441 | 2017-07-11 |
| 1881130060 | Yaazmiyn White | Nurse Practitioner | 8868 Merseyside Ave, Jacksonville, FL 32219-4355 | 2017-01-12 |
| 1821545872 | Anmarie Chandler | Nurse Practitioner | 320 Branscomb Dr Sw Ste A, Jacksonville, AL 36265-3102 | 2016-09-07 |
| 1538523402 | Julia Peters Paul | Nurse Practitioner | 10898 Tarin Dr, Jacksonville, FL 32218-4808 | 2016-04-07 |
| 1487035465 | Aggie Kalyn Hunt | Nurse Practitioner | 237 Old White Street, Suite 1, Jacksonville, NC 28546-6351 | 2015-06-15 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32210 |
Please comment or provide details below to improve the information on JOHANNA MERCEDEZ RUSSELL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.