Individual provider Active NPI

Jennifer Rose Yello, APRN

  • Family Nurse Practitioner
  • Gainesville, FL
National Provider Identifier
1083277917
Registry record updated Oct 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11001672 Issued in FL
Practice address
2846 SW 87TH Way Ste a
Gainesville, FL 32608-9341
Phone
(352) 265-0944
NPI assigned
Apr 16, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2019

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 11001672 FL Primary

Addresses

Primary practice location

2846 SW 87TH Way Ste a
Gainesville, FL 32608-9341

Mailing address

2636 SW 35TH PL Unit 4
Gainesville, FL 32608-7869
Phone (321) 297-3851

Other identifiers 1

IdentifierTypeStateIssuer
102767800MedicaidFL

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11001672FLMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1555372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572307200000",
    "number": "1083277917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2636 SW 35TH PL UNIT 4",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326087869",
            "telephone_number": "321-297-3851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2846 SW 87TH WAY STE A",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326089341",
            "telephone_number": "352-265-0944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YELLO",
        "first_name": "JENNIFER",
        "middle_name": "ROSE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-16",
        "last_updated": "2019-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11001672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102767800",
            "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 Oct 29, 2019; 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.