Individual provider Active NPI

Wykinda Tumesa Fantroy, FNP-C

  • Family Medicine Physician
  • Tampa, FL
National Provider Identifier
1295585016
Registry record updated Mar 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
F03240335 Issued in FL
Practice address
3607 N Garrison St
Tampa, FL 33619-1543
Phone
(813) 789-2262
NPI assigned
Mar 25, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X F03240335 FL Primary

Addresses

Primary practice location

3607 N Garrison St
Tampa, FL 33619-1543

Mailing address

3607 N Garrison St
Tampa, FL 33619-1543
Phone (813) 789-2262

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240524003524 FL Practitioner - Nurse Practitioner 3375811292 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F03240335FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
First Knight Medical Inc CurrentSince May 1, 2024 Accepting new patients

Organizations & group practices 1

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": "1711324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1295585016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3607 N GARRISON ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336191543",
            "telephone_number": "813-789-2262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3607 N GARRISON ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336191543",
            "telephone_number": "813-789-2262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANTROY",
        "first_name": "WYKINDA",
        "middle_name": "TUMESA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-25",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "F03240335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.