Individual provider Active NPI

Carlene K Chambers, APRN

  • Acute Care Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1134875933
Registry record updated Sep 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
11018388 Issued in FL
Practice address
5 Tampa General Cir Ste 300
Tampa, FL 33606-3578
Phone
(813) 251-0793
NPI assigned
Mar 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 11018388 FL Primary

Addresses

Primary practice location

5 Tampa General Cir Ste 300
Tampa, FL 33606-3578

Mailing address

PO Box 1289
Tampa, FL 33601-1289
Phone (813) 251-0793

Other practice location 1

6813 Blue Moon Way
Ruskin, FL 33573-0137
Phone (727) 421-1957

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cchambers184057@direct.tgh.org

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
I20221004002988 FL Practitioner - Nurse Practitioner 7810373545 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ibrahim Heart Clinic PLLCGroup PAC ID 4688958648, 43 clinicians
Heart Care ConsultantsGroup PAC ID 7315004132, 9 clinicians

Practice addresses (Care Compare)

5150 Belfort Rd
BLDG 400
Jacksonville, FL 32256-6026
Phone (904) 580-4730

6310 Health Park Way
Suite 120
Lakewood Ranch, FL 34202-5177

9423 Town Ctr Pkwy
Lakewood Ranch, FL 34202-5134
Phone (941) 907-8951

9423 Town Ctr Pkwy
Lakewood Ranch, FL 34202-5177

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.04 of 100Reported as group
Quality
87.5
Improvement activities
40
Cost
77.51

Merit-based Incentive Payment System (MIPS)

Final score
79.1 of 100Reported as group
Quality
35.98
Promoting interoperability
100
Improvement activities
40
Cost
61.02

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11018388FLMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ibrahim Heart Clinic PLLC CurrentSince Aug 1, 2024 Accepting new patients
Heart Care Consultants CurrentSince Oct 18, 2024 Accepting new patients
Cardiac Vision LLC CurrentSince Feb 1, 2023 Accepting new patients

Locations

215 S US Highway 17
East Palatka, FL 32131
Phone (386) 232-9203

1590 Island Ln
Ste 73
Fleming Island, FL 32003

5150 Belfort Rd
Bldg 400
Jacksonville, FL 32256
Phone (904) 296-0900

6817 Southpoint Pkwy
Ste 203
Jacksonville, FL 32216
Phone (904) 256-9202

7807 Baymeadows Rd E
Ste 209
Jacksonville, FL 32256
Phone (904) 231-1204

6310 Health Park Way
Ste 120
Lakewood Ranch, FL 34202
Phone (941) 907-8951

9423 Town Center Pkwy
Lakewood Ranch, FL 34202
Phone (941) 907-8951

319 W Call St
Ste B
Starke, FL 32091
Phone (904) 368-9102

Interoperability endpoints

  • Direct secure messaging: carlene.chambers.1@30619.direct.athenahealth.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/EDCGCD
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.747353
  • Direct secure messaging: cchambers184057@direct.tgh.org

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 4

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": "1646092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664496000000",
    "number": "1134875933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1289",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336011289",
            "telephone_number": "813-251-0793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 TAMPA GENERAL CIR STE 300",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063578",
            "telephone_number": "813-251-0793"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6813 Blue Moon Way",
            "address_purpose": "LOCATION",
            "city": "Ruskin",
            "state": "FL",
            "postal_code": "335730137",
            "country_code": "US",
            "telephone_number": "727-421-1957",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAMBERS",
        "first_name": "CARLENE",
        "middle_name": "K",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-01",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "11018388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cchambers184057@direct.tgh.org",
            "affiliation": "N",
            "address_1": "5 Tampa General Cir Ste 300",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336063578",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.