Individual provider Active NPI

Jacqueline Danielle Louimaire, ARNP

  • Nurse Practitioner
  • Saint Cloud, FL
National Provider Identifier
1295629657
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11039790 Issued in FL
Practice address
2801 17TH St Ste 202
Saint Cloud, FL 34769-4939
Phone
(407) 906-1328
Fax
(407) 906-1328
NPI assigned
Jun 9, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11039790 FL Primary

Addresses

Primary practice location

2801 17TH St Ste 202
Saint Cloud, FL 34769-4939

Mailing address

3321 Whitestone Cir Unit 206
Kissimmee, FL 34741-7802
Phone (407) 791-4921

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
I20250829000309 FL Practitioner - Nurse Practitioner 7810498037 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Palm Tree Interventional Pain Management PLLCGroup PAC ID 2062771173, 2 clinicians

Practice addresses (Care Compare)

2801 17TH St
Unit 202
Saint Cloud, FL 34769-4939
Phone (407) 906-1328

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11039790FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Palm Tree Interventional Pain Management, PLLC CurrentSince Jun 22, 2025 Accepting new patients
Cardiac Clinic of Sunil M. Kakkar, M.D, P.a PastSince Jun 15, 2025 Accepting new patients

Locations

1381 E Osceola Pkwy
Kissimmee, FL 34744
Phone (407) 906-1328

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1749427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1295629657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3321 WHITESTONE CIR UNIT 206",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347417802",
            "telephone_number": "407-791-4921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 17TH ST STE 202",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347694939",
            "telephone_number": "407-906-1328",
            "fax_number": "407-906-1328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOUIMAIRE",
        "first_name": "JACQUELINE",
        "middle_name": "DANIELLE",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-09",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11039790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, FL

Sources for this page

Verify at the official NPI Registry.