Individual provider Active NPI

Michelle Lee Jampol, APRN

  • Pediatric Nurse Practitioner
  • Port St Lucie, FL
National Provider Identifier
1255450953
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
APRN9179550 Issued in FL
Practice address
9401 SW Discovery Way Ste 102
Port St Lucie, FL 34987-2381
Phone
(772) 834-7362
Fax
(772) 618-2024
NPI assigned
Mar 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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 APRN9179550 FL Primary

Addresses

Primary practice location

9401 SW Discovery Way Ste 102
Port St Lucie, FL 34987-2381

Mailing address

9401 SW Discovery Way Ste 102
Port St Lucie, FL 34987-2381
Phone (772) 834-7362

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
APRN9179550FLMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Endocrine and Metabolic Center of Florida, PLLC CurrentSince Apr 28, 2024 Accepting new patients
Vitalmd Group Holding LLC PastSince Apr 28, 2024 Accepting new patients

Locations

9401 SW Discovery Way
Ste 102
Port St Lucie, FL 34987
Phone (772) 834-7362

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.

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1255450953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9401 SW DISCOVERY WAY STE 102",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349872381",
            "telephone_number": "772-834-7362",
            "fax_number": "772-618-2024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9401 SW DISCOVERY WAY STE 102",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349872381",
            "telephone_number": "772-834-7362",
            "fax_number": "772-618-2024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMPOL",
        "first_name": "MICHELLE",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "APRN9179550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; 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.