Individual provider Active NPI

Jessica Tapp

  • Family Nurse Practitioner
  • New Smyrna Beach, FL
National Provider Identifier
1093346769
Registry record updated Jan 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11005985 Issued in FL
Practice address
1055 N Dixie Fwy
New Smyrna Beach, FL 32168-6201
Phone
(386) 423-0505
NPI assigned
Jan 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2020

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 APRN11005985 FL Primary

Addresses

Primary practice location

1055 N Dixie Fwy
New Smyrna Beach, FL 32168-6201

Mailing address

1055 N Dixie Fwy Ste 1
New Smyrna Beach, FL 32168-6200
Phone (386) 423-0505

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
I20200404000315 FL Practitioner - Nurse Practitioner 9234568734 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PCCC of Volusia LLCGroup PAC ID 7911910237, 15 clinicians
Beachside Medical CenterGroup PAC ID 5395053599, 3 clinicians

Practice addresses (Care Compare)

1055 N Dixie Fwy
Suite 1
New Smyrna Beach, FL 32168-6201
Phone (386) 423-0505

233 N Causeway
New Smyrna Beach, FL 32169-5239
Phone (386) 957-9850

Hospital & facility affiliations

  • Adventhealth New Smyrna Beach Hospital, New Smyrna Beach, FL, CCN 100014

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11005985FLMDFamily Nurse Practitioner

Practice roles (2 of 4)

OrganizationSpecialtyStatusNew patients
Beachside Medical Center CurrentSince Nov 2, 2022 Accepting new patients
NDC of Volusia LLC PastSince Feb 2, 2020 Accepting new patients

Locations

233 N Causeway
New Smyrna Beach, FL 32169
Phone (386) 957-9850

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

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

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1580342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580342400000",
    "number": "1093346769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 N DIXIE FWY STE 1",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321686200",
            "telephone_number": "386-423-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 N DIXIE FWY",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321686201",
            "telephone_number": "386-423-0505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAPP",
        "first_name": "JESSICA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-30",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11005985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Smyrna Beach, FL

Sources for this page

Verify at the official NPI Registry.