Organization Active NPI

Joanna Mulder NP Inc

  • Nurse Practitioner
  • Riverview, FL
National Provider Identifier
1144756172
Registry record updated Mar 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
JOANNA MULDER NP INC
Practice address
13739 Ogakor Dr
Riverview, FL 33579-2303
Phone
(813) 940-6046
Fax
(866) 451-4607
NPI assigned
May 11, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2026

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

Authorized official

Name
Stephanie E Ellison
Title
Owner
Phone
(813) 376-0742

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

13739 Ogakor Dr
Riverview, FL 33579-2303

Mailing address

13739 Ogakor Dr
Riverview, FL 33579-2303
Phone (813) 940-6046

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170928003956 FL Part B Supplier - Clinic/Group Practice 2264707389 Receives reassigned benefits from 3 practitioners

National Provider Directory

National Provider Directory

Locations

311 W Sadie St
Brandon, FL 33510
Phone (813) 523-6014

804 W Bloomingdale Ave
Ofc
Brandon, FL 33511
Phone (813) 643-2093

825 Telfair Rd
Brandon, FL 33510
Phone (813) 655-1969

208 Marveline Dr
Lakeland, FL 33815
Phone (813) 410-8946

10804 Hackney Dr
Riverview, FL 33578
Phone (813) 671-1895

205 4th Ave N
#205
Saint Petersburg, FL 33701
Phone (727) 894-8427

6622 Stark Rd
Seffner, FL 33584
Phone (813) 623-3370

3808 N Lincoln Ave
Tampa, FL 33607
Phone (813) 443-2714

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774483200000",
    "number": "1144756172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13739 OGAKOR DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335792303",
            "telephone_number": "813-940-6046",
            "fax_number": "866-451-4607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13739 OGAKOR DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335792303",
            "telephone_number": "813-940-6046",
            "fax_number": "866-451-4607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOANNA MULDER NP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-11",
        "last_updated": "2026-03-26",
        "certification_date": "2026-03-26",
        "status": "A",
        "authorized_official_last_name": "ELLISON",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-376-0742"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverview, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.