{
"Npi": {
"NPI": "1104636596",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "MARCUS-ATKINSON",
"FirstName": "ALEXIS",
"MiddleName": null,
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "705 WELLS RD STE 300",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ORANGE PARK",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "32073-2982",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "904-282-6331",
"MailingAddressFaxNumber": "904-866-4818",
"FirstLinePracticeLocationAddress": "10250 NORMANDY BLVD UNIT 802",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "JACKSONVILLE",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "32221-8064",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "904-379-7155",
"PracticeLocationAddressFaxNumber": "904-379-7165",
"EnumerationDate": "01/09/2025",
"LastUpdateDate": "03/10/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "363LG0600X",
"TaxonomyName": "Gerontology Nurse Practitioner",
"LicenseNumber": "APRN11037045",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363L00000X",
"TaxonomyName": "Nurse Practitioner",
"LicenseNumber": "APRN11037045",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}