FIRST COAST COMMUNITY WELLNESS SERVICES LLC
NPI 1336879097
Nurse Practitioner - Psychiatric/Mental Health in Jacksonville, FL
About First Coast Community Wellness Services Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
FIRST COAST COMMUNITY WELLNESS SERVICES LLC (NPI 1336879097) is a healthcare organization registered as a psychiatric/mental health in Jacksonville, Florida and active in the NPI registry since June 2022. The organization lists Monica Johnson, Mgr, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
First Coast Community Wellness Services Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to First Coast Community Wellness Services LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 10D2269927
First Coast Community Wellness Services, LLC · Jacksonville, FLFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is First Coast Community Wellness Services LLC's NPI number?
The NPI number for First Coast Community Wellness Services LLC is 1336879097. It was assigned to this organization in the NPPES registry on June 15, 2022.
Where is First Coast Community Wellness Services LLC located?
First Coast Community Wellness Services LLC is located at 5610 Fort Caroline Rd, Jacksonville, FL 32277. The listed phone number is (904) 374-4637.
What is First Coast Community Wellness Services LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is First Coast Community Wellness Services LLC enrolled in Medicare?
Yes. First Coast Community Wellness Services LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through First Coast Community Wellness Services LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to First Coast Community Wellness Services LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for First Coast Community Wellness Services LLC was last updated on May 23, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# First Coast Community Wellness Services Llc · NPI 1336879097
Psychiatric/Mental Health organization in Jacksonville, Florida. Organization record, active in the CMS NPPES registry since June 15, 2022.
## Identity
- **NPI:** 1336879097 (Entity type: Organization)
- **Enumerated:** June 15, 2022
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **Organization subpart:** No
- **Authorized official:** Monica Johnson, MGR
## Practice location
- **Address:** 5610 FORT CAROLINE RD, Jacksonville, FL 32277-1799
- **Phone:** (904) 374-4637
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 23, 2023
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1336879097) · Data from the CMS NPPES public registry.