Individual provider Active NPI

Connie Ann Jongewaard, MSN, ARNP, FNP-BC

  • Family Nurse Practitioner
  • Ponte Vedra Beach, FL
National Provider Identifier
1164795746
Registry record updated Feb 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP3269412 Issued in FL
Practice address
209 Ponte Vedra Park Dr
Ponte Vedra Beach, FL 32082-6600
Phone
(904) 273-6200
Fax
(904) 273-6100
NPI assigned
Feb 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2012

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 ARNP3269412 FL Primary

Addresses

Primary practice location

209 Ponte Vedra Park Dr
Ponte Vedra Beach, FL 32082-6600

Mailing address

209 Ponte Vedra Park Dr
Ponte Vedra Beach, FL 32082-6600
Phone (904) 273-6200

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
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP3269412FLMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1329091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329091200000",
    "number": "1164795746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 PONTE VEDRA PARK DR",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320826600",
            "telephone_number": "904-273-6200",
            "fax_number": "904-273-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 PONTE VEDRA PARK DR",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320826600",
            "telephone_number": "904-273-6200",
            "fax_number": "904-273-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONGEWAARD",
        "first_name": "CONNIE",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "MSN, ARNP, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-13",
        "last_updated": "2012-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP3269412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponte Vedra Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2012; 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.