Individual provider Active NPI

Debra Jeakle, ARNP

  • Family Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1245292739
Registry record updated Oct 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP2568812 Issued in FL
Practice address
10004 N Dale Mabry Hwy Ste 101
Tampa, FL 33618-4421
Phone
(813) 931-3999
Fax
(813) 377-1391
NPI assigned
Apr 3, 2006
Last updated
Oct 1, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2018

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 ARNP2568812 FL Primary

Addresses

Primary practice location

10004 N Dale Mabry Hwy Ste 101
Tampa, FL 33618-4421

Mailing address

38135 Market SQ
Zephyrhills, FL 33542-7505
Phone (813) 528-4975

Other identifiers 1

IdentifierTypeStateIssuer
003865800MedicaidFL

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
Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538352000000",
    "number": "1245292739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38135 MARKET SQ",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335427505",
            "telephone_number": "813-528-4975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10004 N DALE MABRY HWY STE 101",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336184421",
            "telephone_number": "813-931-3999",
            "fax_number": "813-377-1391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEAKLE",
        "first_name": "DEBRA",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-03",
        "last_updated": "2018-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP2568812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003865800",
            "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 Oct 1, 2018; 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.