Active NPI
Sally Jaye Granger, ARNP
- Nurse Practitioner
- Tampa, FL
National Provider Identifier
1235385477
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- ARNP2053652
- Practice address
- 12502 Usf Pine Dr
Tampa, FL 33612-9411 - Phone
- (813) 975-7117
- Fax
- (813) 975-7129
- NPI assigned
- Aug 7, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | ARNP2053652 | FL | Primary |
Addresses
Primary practice location
12502 Usf Pine Dr
Tampa, FL 33612-9411
Mailing address
PO Box 8500
Lockbox #7642
Philadelphia, PA 19178-7642
Phone (813) 281-8115
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000375000 | Medicaid | FL |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ARNP2053652 | FL | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1218067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369180800000",
"number": "1235385477",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8500",
"address_2": "LOCKBOX #7642",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191787642",
"telephone_number": "813-281-8115",
"fax_number": "813-281-8656"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12502 USF PINE DR",
"city": "TAMPA",
"state": "FL",
"postal_code": "336129411",
"telephone_number": "813-975-7117",
"fax_number": "813-975-7129"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRANGER",
"first_name": "SALLY",
"middle_name": "JAYE",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-07",
"last_updated": "2013-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "FL",
"license": "ARNP2053652",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000375000",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.