<unavail> in Live Oak, FL - Medicare Nurse Practitioner

is a medicare enrolled primary clinic (Nurse Practitioner - Family) in Live Oak, Florida. The current practice location for is 112 Irvin Ave Sw, Live Oak, Florida. For appointments, you can reach them via phone at (386) 647-6144. The mailing address for is 8405 127th Dr, Live Oak, Florida and phone number is (386) 647-6144.

is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1407636582. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (386) 647-6144.

Contact Information


	112 Irvin Ave Sw Live Oak FL 32064-2214
	(386) 647-6144
	Not Available

Map and Direction

Primary Care Clinic Profile

Full Name
Speciality	Nurse Practitioner
Location	112 Irvin Ave Sw, Live Oak, Florida
Authorized Official Name and Position	Aymee Wilson (OWNER)
Authorized Official Contact	3863306380
Accepts Medicare Insurance	Yes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
8405 127th Dr Live Oak FL 32060-8835 Ph: (386) 647-6144	112 Irvin Ave Sw Live Oak FL 32064-2214 Ph: (386) 647-6144

NPI Details:

NPI Number	1407636582
Provider Enumeration Date	10/04/2023
Last Update Date	02/08/2024

Medicare PECOS Information:

Medicare PECOS PAC ID	8921451469
Medicare Enrollment ID	O20240131002623

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1407636582	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	(* (Not Available))	Secondary
363LF0000X	Nurse Practitioner - Family	(* (Not Available))	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. acts as a billing entity for following providers:

Provider Name	Cheryl Renae Abersold
Provider Type	Practitioner - Nurse Practitioner
Provider Identifiers	NPI Number: 1003457623 PECOS PAC ID: 0143663740 Enrollment ID: I20240212000655

Reviews and Comments

Nurse Practitioner in Live Oak, FL

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- Medicare Primary Care in Live Oak, FL