Individual provider Active NPI

Jennifer Evans

  • Family Nurse Practitioner
  • Lauderdale Lakes, FL
National Provider Identifier
1083094718
Registry record updated Apr 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11016104 Issued in FL
Practice address
4850 W Oakland Park Blvd Ste 136
Lauderdale Lakes, FL 33313-7277
Phone
(844) 665-4827
NPI assigned
Jun 8, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 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 APRN11016104 FL Primary

Addresses

Primary practice location

4850 W Oakland Park Blvd Ste 136
Lauderdale Lakes, FL 33313-7277

Mailing address

8400 NW 33Rd St Ste 201
Doral, FL 33122-1937
Phone (844) 665-4827

Other names 1

  • Jennifer T Cave Former name

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
I20230119003143 FL Practitioner - Nurse Practitioner 2567770290

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11016104FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Integrative Regional Medical Center, P.C. Nurse Practitioner Past Accepting new patients

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": "1433721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1083094718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8400 NW 33RD ST STE 201",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331221937",
            "telephone_number": "844-665-4827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 W OAKLAND PARK BLVD STE 136",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333137277",
            "telephone_number": "844-665-4827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-08",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11016104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "CAVE",
            "middle_name": "T",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lauderdale Lakes, FL

Sources for this page

Verify at the official NPI Registry.