Individual provider Active NPI

Jennifer Lee Leal, A.R.N.P

  • Primary Care Nurse Practitioner
  • Trinity, FL
National Provider Identifier
1164616975
Registry record updated May 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
ARNP3072012 Issued in FL
Practice address
2137 Little Rd
Trinity, FL 34655-4410
Phone
(727) 372-6760
Fax
(727) 372-6808
NPI assigned
Sep 5, 2007
Last updated
May 24, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X ARNP3072012 FL Primary

Addresses

Primary practice location

2137 Little Rd
Trinity, FL 34655-4410

Mailing address

2137 Little Rd
Trinity, FL 34655-4410
Phone (727) 372-6760

Other identifiers 1

IdentifierTypeStateIssuer
306771800MedicaidFL

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
ARNP3072012FLMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
East Lake Pediatrics CurrentSince Jun 18, 2023 Accepting new patients

Locations

200 Pine Ave N
Oldsmar, FL 34677

4150 Woodlands Pkwy
Ste B
Palm Harbor, FL 34685
Phone (727) 461-2757

2137 Little Rd
Trinity, FL 34655
Phone (727) 372-6760

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.60913

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1188950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1164616975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2137 LITTLE RD",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346554410",
            "telephone_number": "727-372-6760",
            "fax_number": "727-372-6808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2137 LITTLE RD",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346554410",
            "telephone_number": "727-372-6760",
            "fax_number": "727-372-6808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEAL",
        "first_name": "JENNIFER",
        "middle_name": "LEE",
        "credential": "A.R.N.P",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-05",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "ARNP3072012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "306771800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Trinity, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; 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.