Individual provider Active NPI

Jennifer Kaufmann, APRN

  • Family Nurse Practitioner
  • Debary, FL
National Provider Identifier
1073197281
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11012018 Issued in FL
Practice address
70 Fox Ridge CT Ste a
Debary, FL 32713-2752
Phone
(386) 668-6321
NPI assigned
May 12, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11012018 FL Primary

Addresses

Primary practice location

70 Fox Ridge CT Ste a
Debary, FL 32713-2752

Mailing address

70 Fox Ridge CT Ste a
Debary, FL 32713-2752
Phone (386) 668-6321

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210714002122 FL Practitioner - Nurse Practitioner 9931501871 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

70 Fox Ridge CT
Suite a
Debary, FL 32713-2752
Phone (386) 668-6321

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11012018FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ultimate Medical Clinic LLC CurrentSince Sep 30, 2024 Accepting new patients
Neurology of Central Florida PastSince Jun 1, 2024 Accepting new patients

Locations

70 Fox Ridge Ct
Ste A
Debary, FL 32713
Phone (386) 668-4411

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FIDECA

Organizations & group practices 2

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": "1620777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1073197281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 FOX RIDGE CT STE A",
            "city": "DEBARY",
            "state": "FL",
            "postal_code": "327132752",
            "telephone_number": "386-668-6321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 FOX RIDGE CT STE A",
            "city": "DEBARY",
            "state": "FL",
            "postal_code": "327132752",
            "telephone_number": "386-668-6321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUFMANN",
        "first_name": "JENNIFER",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-12",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11012018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Debary, FL

Sources for this page

Verify at the official NPI Registry.