Jurry Om, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11032788 Issued in FL

Practice address

707 W Eau Gallie Blvd
Melbourne, FL 32935-5958

Phone

(321) 727-3223

NPI assigned

Sep 3, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Bermax II LLC

  • Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
  • Melbourne, FL
  • NPI 1326374901
  NPD
• New West Physicians Inc

  • Internal Medicine Physician
  • Golden, CO
  • NPI 1427010859
  NPD (past)

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

{
    "created_epoch": "1567468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1053969014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8880 NAPOLO DR",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329407499",
            "telephone_number": "303-501-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 W EAU GALLIE BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329355958",
            "telephone_number": "321-727-3223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9695 S Yosemite St Ste 324",
            "address_purpose": "LOCATION",
            "city": "Lone Tree",
            "state": "CO",
            "postal_code": "801242890",
            "country_code": "US",
            "telephone_number": "303-706-9054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OM",
        "first_name": "JURRY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-03",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "MO9002990",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0994708-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11032788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Olivieri
• Kristopher J Olsen, PHD
• Sara Olson
• Jay Edward Olsson, DO PROF ASSOCIATIONN
• Om Urology LLC
• Omni Healthcare, Inc
• Omni Healthcare, Inc.
• Omni Healthcare, Inc.
• Omnihealthcare Inc
• On Pointe Orthopaedics LLC

• Family Nurse Practitioner in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 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.