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SUWANNEE OAKS MEDICAL PRIMARY AND WELLNESS CLINIC
NPI 1407636582
Nurse Practitioner - Family in Live Oak, FL

Active since October 04, 2023
112 IRVIN AVE SW, LIVE OAK, FL 32064(386) 647-6144 Get Directions Write a Review

NPPES record last updated: February 8, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 8, 2024, Oct 13, 2023, Oct 4, 2023 (3 updates tracked since 2023).

About Suwannee Oaks Medical Primary And Wellness Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUWANNEE OAKS MEDICAL PRIMARY AND WELLNESS CLINIC (NPI 1407636582) is a healthcare organization registered as a family in Live Oak, Florida and active in the NPI registry since October 2023. The organization lists Aymee Wilson, Owner, as its authorized official.

NPPES Registry Identity

NPI1407636582
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business Name5JAGHEALTH, PLLC
Location Address112 IRVIN AVE SWLive Oak, FL 32064-2214
Mailing Address8405 127th DrLive Oak, FL 32060-8835 · (386) 647-6144
Phone(386) 647-6144
Organization SubpartNo
Authorized OfficialAymee WilsonOwner · (386) 330-6380
Enumeration DateOctober 4, 2023
Last NPPES UpdateFebruary 8, 20243 updates tracked since enumeration
NPPES CertifiedFebruary 8, 2024
✔ NPI 1407636582 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
Also ListedFamily MedicineTaxonomy 207Q00000X
112 IRVIN AVE SW, Live Oak, FL 32064
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Other Names 1

Doing Business AsSuwannee Oaks Medical Primary And Wellness Clinic

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DESIREE ROSE GOLDSTEIN
Specialist/Technologist (Speech-Language Assistant)
112 IRVIN AVE SW
LIVE OAK, FL 32064
Suwannee County (678) 523-4884
AYMEE WILSON ARNP
Nurse Practitioner (Family)
112 IRVIN AVE SW
LIVE OAK, FL 32064
Suwannee County (386) 330-6380

Frequently 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 5jaghealth, PLLC's NPI number?

The NPI number for 5jaghealth, PLLC is 1407636582. It was assigned to this organization in the NPPES registry on October 4, 2023. The provider is doing business as Suwannee Oaks Medical Primary And Wellness Clinic.

Where is 5jaghealth, PLLC located?

5jaghealth, PLLC is located at 112 Irvin Ave SW, Live Oak, FL 32064. The listed phone number is (386) 647-6144.

What is 5jaghealth, PLLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for 5jaghealth, PLLC was last updated on February 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.