Individual provider Active NPI

Brooke Alecia Rupert, ARNP

  • Pediatric Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1043672827
Registry record updated Feb 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
ARNP9339338 Issued in FL
Practice address
4710 N. Habana Avenue
Suite #307
Tampa, FL 33614-7151
Phone
(813) 874-2000
Fax
(813) 875-9303
NPI assigned
Mar 22, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN9339338 FL
Pediatric Nurse Practitioner 363LP0200X ARNP9339338 FL Primary

Addresses

Primary practice location

4710 N. Habana Avenue
Suite #307
Tampa, FL 33614-7151

Mailing address

5950 S Florida Ave
Lakeland, FL 33813-2532
Phone (863) 688-3550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RN9339338FLMDRegistered Nurse
ARNP9339338FLMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jose R. Foradada, III, MD, P.a. Pediatrics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: brookerupert@lp.allscriptsdirect.net

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487548800000",
    "number": "1043672827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5950 S FLORIDA AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132532",
            "telephone_number": "863-688-3550",
            "fax_number": "863-687-8969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4710 N. HABANA AVENUE",
            "address_2": "SUITE #307",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336147151",
            "telephone_number": "813-874-2000",
            "fax_number": "813-875-9303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUPERT",
        "first_name": "BROOKE",
        "middle_name": "ALECIA",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-22",
        "last_updated": "2017-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9339338",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "ARNP9339338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.