Individual provider Active NPI

Virginia Sue Shreve, APRN

  • Nurse Practitioner
  • Gainesville, FL
National Provider Identifier
1053497420
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN2153082 Issued in FL
Practice address
4627 NW 53Rd Avenue
Gainesville, FL 32606-4627
Phone
(352) 335-8888
Fax
(352) 335-9427
NPI assigned
Oct 28, 2006
Last updated
Sep 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN2153082 FL Primary

Addresses

Primary practice location

4627 NW 53Rd Avenue
Gainesville, FL 32606-4627

Mailing address

900 S Pine Island Rd Ste 800
Plantation, FL 33324-3923
Phone (352) 335-8888

Other identifiers 1

IdentifierTypeStateIssuer
003778800MedicaidFL

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN2153082FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Pediatrics PA Pediatrics Current Accepting new patients
Saltzman, Tanis, Pittel, Levin and Jacobson, LLC Pediatrics PastSince Nov 21, 2021 Accepting new patients
Saltzman, Tanis, Pittell, Levin and Jacobson Pediatrics Past Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1161993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1053497420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 S PINE ISLAND RD STE 800",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333243923",
            "telephone_number": "352-335-8888",
            "fax_number": "352-335-9427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4627 NW 53RD AVENUE",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326064627",
            "telephone_number": "352-335-8888",
            "fax_number": "352-335-9427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHREVE",
        "first_name": "VIRGINIA",
        "middle_name": "SUE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-28",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN2153082",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003778800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; 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.