Individual provider Active NPI

Diana C Jennings, ARNP

  • Family Nurse Practitioner
  • Zephyrhills, FL
National Provider Identifier
1144731571
Registry record updated Dec 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9310321 Issued in FL
Practice address
38051 Market SQ
Zephyrhills, FL 33542-7504
Phone
(813) 780-8085
NPI assigned
Oct 12, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2017

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 9310321 FL Primary

Addresses

Primary practice location

38051 Market SQ
Zephyrhills, FL 33542-7504

Mailing address

38135 Market SQ
Zephyrhills, FL 33542-7505
Phone (352) 567-0188

Other names 1

  • Diana Maldonado Miranda 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
I20180110002159 FL Practitioner - Nurse Practitioner 3173882586 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohi West Medical Group II LLCGroup PAC ID 0648631192, 407 clinicians

Practice addresses (Care Compare)

38051 Market Square Dr
Suite 123
Zephyrhills, FL 33542-7504
Phone (813) 780-8085

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9310321FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ohi West Medical Group II LLC CurrentSince May 1, 2024 Accepting new patients
Florida Medical Clinic LLC CurrentSince Nov 13, 2017 Accepting new patients
Florida Medical Clinic, LLC CurrentSince Nov 13, 2017 Accepting new patients
Ohi West Medical Group II LLC CurrentSince May 1, 2024 Accepting new patients
Ohi West Medical Group II LLC Past Accepting new patients

Locations

38051 Market Square Dr
Zephyrhills, FL 33542
Phone (813) 779-2057

38021 Market Square Dr
Zephyrhills, FL 33542
Phone (813) 715-0374

38051 Market Square Dr
#123
Zephyrhills, FL 33542

38135 Market Square Dr
Zephyrhills, FL 33542
Phone (352) 567-0188

38135 Market Square Dr
Ste 101
Zephyrhills, FL 33542
Phone (813) 788-7651

38051 Market Square Dr
Ste 123
Zephyrhills, FL 33542
Phone (813) 780-8085

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 5

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": "1507766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512345600000",
    "number": "1144731571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38135 MARKET SQ",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335427505",
            "telephone_number": "352-567-0188",
            "fax_number": "813-355-5101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38051 MARKET SQ",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335427504",
            "telephone_number": "813-780-8085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "DIANA",
        "middle_name": "C",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-12",
        "last_updated": "2017-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9310321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANA",
            "last_name": "MALDONADO MIRANDA",
            "credential": "ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Zephyrhills, FL

Sources for this page

Verify at the official NPI Registry.