Individual provider Active NPI

Jennifer L Vesper, M.D.

  • Dermatology Physician
  • Bradenton, FL
National Provider Identifier
1265497804
Registry record updated Sep 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
ME0066265 Issued in FL
Practice address
300 Riverside Dr E
#2200
Bradenton, FL 34208-1008
Phone
(941) 748-3376
Fax
(941) 748-7562
NPI assigned
Apr 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X ME0066265 FL Primary

Addresses

Primary practice location

300 Riverside Dr E
#2200
Bradenton, FL 34208-1008

Mailing address

300 Riverside Dr E
#2200
Bradenton, FL 34208-1008
Phone (941) 748-3376

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101115000912 FL Practitioner - Dermatology 4880781939 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME0066265FLMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Waterside Dermatology PLLC Dermatology CurrentSince Aug 1, 2023 Accepting new patients
Susan H Weinkle, MD Dermatology CurrentSince Dec 1, 2024 Accepting new patients
Weinkle Dermatology, Inc. Dermatology CurrentSince Dec 1, 2024 Accepting new patients

Locations

300 Riverside Dr E
Ste 2200
Bradenton, FL 34208
Phone (941) 748-3376

5601 21st Ave W
Ste B
Bradenton, FL 34209
Phone (941) 794-5432

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285804800000",
    "number": "1265497804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 RIVERSIDE DR E",
            "address_2": "#2200",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342081008",
            "telephone_number": "941-748-3376",
            "fax_number": "941-748-7562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 RIVERSIDE DR E",
            "address_2": "#2200",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342081008",
            "telephone_number": "941-748-3376",
            "fax_number": "941-748-7562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VESPER",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-18",
        "last_updated": "2010-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME0066265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.