Individual provider Active NPI

Janda L Moldenhauer, ARNP-BC

  • Adult Health Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1104892777
Registry record updated Nov 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
ARNP 9172233 Issued in FL
Practice address
13000 Bruce B Downs Blvd
Tampa, FL 33612-4745
Phone
(813) 972-2000
Fax
(813) 978-5834
NPI assigned
Feb 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X ARNP 9172233 FL Primary

Addresses

Primary practice location

13000 Bruce B Downs Blvd
Tampa, FL 33612-4745

Mailing address

15010 Eaglepark PL
Lithia, FL 33547-3802
Phone (813) 972-2000

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
ARNP 9172233FLMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194912000000",
    "number": "1104892777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15010 EAGLEPARK PL",
            "city": "LITHIA",
            "state": "FL",
            "postal_code": "335473802",
            "telephone_number": "813-972-2000",
            "fax_number": "813-978-5834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13000 BRUCE B DOWNS BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336124745",
            "telephone_number": "813-972-2000",
            "fax_number": "813-978-5834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLDENHAUER",
        "first_name": "JANDA",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "ARNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-24",
        "last_updated": "2007-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP 9172233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2007; 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.