Individual provider Active NPI

Jessica Ann Gunderson, APRN

  • Family Nurse Practitioner
  • Venice, FL
National Provider Identifier
1174386379
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11030821 Issued in FL
Practice address
825 Venetian Pkwy
Venice, FL 34285-7163
Phone
(941) 483-5730
Fax
(941) 483-5740
NPI assigned
Feb 1, 2024
Last updated
Feb 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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 APRN11030821 FL Primary

Addresses

Primary practice location

825 Venetian Pkwy
Venice, FL 34285-7163

Mailing address

825 Venetian Pkwy
Venice, FL 34285-7163
Phone (941) 483-5730

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
I20240227000685 FL Practitioner - Nurse Practitioner 5890130108 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Digestive Health Specialists, LLPGroup PAC ID 6507054582, 86 clinicians

Practice addresses (Care Compare)

900 Pine St
Suite 211
Englewood, FL 34223-4458
Phone (941) 473-8881

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11030821FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Digestive Health Specialists, LLP CurrentSince Oct 1, 2024 Accepting new patients
Neurosurgical Spine Institute LLC PastSince Aug 1, 2024 Accepting new patients

Locations

1886 59th St W
Bradenton, FL 34209
Phone (941) 361-1100

900 Pine St
Ste 211
Englewood, FL 34223
Phone (941) 475-3784

10920 Technology Ter
Lakewood Ranch, FL 34211
Phone (941) 216-4835

2400 Harbor Blvd
Ste 15
Pt Charlotte, FL 33952
Phone (941) 483-4000

825 Venetian Pkwy
Venice, FL 34285
Phone (941) 483-5730

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 2

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.

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": "1706745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1174386379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 VENETIAN PKWY",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342857163",
            "telephone_number": "941-483-5730",
            "fax_number": "941-483-5740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 VENETIAN PKWY",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342857163",
            "telephone_number": "941-483-5730",
            "fax_number": "941-483-5740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNDERSON",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-01",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11030821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Venice, FL

Sources for this page

Verify at the official NPI Registry.