Active NPI
Koleen Arieta Dumindin, APRN
- Nurse Practitioner
- Bradenton, FL
National Provider Identifier
1255890851
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 11001539
- Practice address
- 203 3Rd Ave E
Bradenton, FL 34208-1013 - Phone
- (941) 741-8633
- NPI assigned
- Mar 14, 2019
- 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 | 11001539 | FL | Primary |
Addresses
Primary practice location
203 3Rd Ave E
Bradenton, FL 34208-1013
Mailing address
4750 Marsh Field Rd
Sarasota, FL 34235-5695
Phone (813) 753-5976
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11001539 | Other | FL | LICENSE NUMBER |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | manateesleep@gmail.com | Health Information Exchange (HIE) |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11001539 | FL | MD | Nurse Practitioner |
Networks
- Freedom Health HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1552521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1552521600000",
"number": "1255890851",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4750 MARSH FIELD RD",
"city": "SARASOTA",
"state": "FL",
"postal_code": "342355695",
"telephone_number": "813-753-5976"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "203 3RD AVE E",
"city": "BRADENTON",
"state": "FL",
"postal_code": "342081013",
"telephone_number": "941-741-8633"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUMINDIN",
"first_name": "KOLEEN",
"middle_name": "ARIETA",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-14",
"last_updated": "2019-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "FL",
"license": "11001539",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "11001539",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "manateesleep@gmail.com",
"affiliation": "N",
"endpointDescription": "direct address",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "health information",
"address_1": "203 3rd Ave E",
"city": "Bradenton",
"state": "FL",
"country_code": "US",
"postal_code": "342081013",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Bradenton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.