Individual provider Active NPI

Tara Maureen Grenon, APRN

  • Family Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1255228326
Registry record updated Jun 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11038733 Issued in FL
Practice address
4100 W Kennedy Blvd Ste 130
Tampa, FL 33609-2250
Phone
(813) 644-9964
NPI assigned
Jun 21, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 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 11038733 FL Primary

Addresses

Primary practice location

4100 W Kennedy Blvd Ste 130
Tampa, FL 33609-2250

Mailing address

17441 Hugh LN
Land O Lakes, FL 34638-7870
Phone (813) 404-8480

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

State licenses

LicenseStateTypeSpecialty
11038733FLMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1750464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750464000000",
    "number": "1255228326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17441 HUGH LN",
            "city": "LAND O LAKES",
            "state": "FL",
            "postal_code": "346387870",
            "telephone_number": "813-404-8480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 W KENNEDY BLVD STE 130",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336092250",
            "telephone_number": "813-644-9964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRENON",
        "first_name": "TARA",
        "middle_name": "MAUREEN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-21",
        "last_updated": "2025-06-21",
        "certification_date": "2025-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11038733",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jun 21, 2025; 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.