Individual provider Active NPI

Jerilyn Anne Summers, ARNP FNP-C

  • Family Nurse Practitioner
  • Port Charlotte, FL
National Provider Identifier
1154786267
Registry record updated Dec 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP 2826482 Issued in FL
Practice address
19531 Cochran Blvd
Port Charlotte, FL 33948-2081
Phone
(941) 235-3535
NPI assigned
Dec 17, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2015

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 ARNP 2826482 FL Primary

Addresses

Primary practice location

19531 Cochran Blvd
Port Charlotte, FL 33948-2081

Mailing address

264 Valdiva St
Punta Gorda, FL 33983-5626
Phone (941) 258-6186

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
I20160209000043 FL Practitioner - Nurse Practitioner 9739483983 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The University of Central Florida Board of TrusteesGroup PAC ID 9739181470, 43 clinicians

Practice addresses (Care Compare)

3400 Quadrangle Blvd
Orlando, FL 32817-1492
Phone (407) 882-4814

Hospital & facility affiliations

  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP 2826482FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Central Florida Board of Trustees CurrentSince Oct 1, 2022 Accepting new patients
Aparna Hernandez MD PA CurrentSince Apr 5, 2022 Accepting new patients
The University of Central Florida Board of Trustees Current Accepting new patients
Communication Disorders Clinic Past Accepting new patients

Locations

5979 Vineland Rd
Ste 310
Orlando, FL 32819
Phone (407) 345-0005

3400 Quadrangle Blvd
Orlando, FL 32817
Phone (407) 266-3627

Interoperability endpoints

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

Organizations & group practices 4

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 2

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": "1450310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450310400000",
    "number": "1154786267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "264 VALDIVA ST",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339835626",
            "telephone_number": "941-258-6186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19531 COCHRAN BLVD",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339482081",
            "telephone_number": "941-235-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMMERS",
        "first_name": "JERILYN",
        "middle_name": "ANNE",
        "credential": "ARNP FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-17",
        "last_updated": "2015-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP 2826482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

Verify at the official NPI Registry.