Individual provider Active NPI

Pamela Pieper, MSN, PNP

  • Pediatric Nurse Practitioner
  • Gainesville, FL
National Provider Identifier
1194708065
Registry record updated Nov 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
1589572 Issued in FL
Practice address
101 S Newell Drive
Gainesville, FL 32611
Phone
(904) 244-3913
Fax
(904) 244-3870
NPI assigned
Nov 23, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 1589572 FL Primary

Addresses

Primary practice location

101 S Newell Drive
Gainesville, FL 32611

Mailing address

PO Box 100197
Gainesville, FL 32610-0197
Phone (904) 244-3913

Other identifiers 2

IdentifierTypeStateIssuer
000909774BMedicaidGA
3006565-00MedicaidFL

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)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
1589572FLMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257465600000",
    "number": "1194708065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100197",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100197",
            "telephone_number": "904-244-3913",
            "fax_number": "904-244-3870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S NEWELL DRIVE",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "32611",
            "telephone_number": "904-244-3913",
            "fax_number": "904-244-3870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIEPER",
        "first_name": "PAMELA",
        "credential": "MSN, PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-23",
        "last_updated": "2009-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "1589572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000909774B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3006565-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2009; 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.