Individual provider Active NPI

Jennifer B Hartman, CRNP

  • Pediatric Nurse Practitioner
  • Cape Coral, FL
National Provider Identifier
1295729887
Registry record updated Oct 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
APRN11026698 Issued in FL
Practice address
632 Del Prado Blvd N Ste 301
Cape Coral, FL 33909-2278
Phone
(239) 768-2111
Fax
(239) 482-4404
NPI assigned
Sep 9, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209003287 IL
Pediatric Nurse Practitioner 363LP0200X APRN11026698 FL Primary

Addresses

Primary practice location

632 Del Prado Blvd N Ste 301
Cape Coral, FL 33909-2278

Mailing address

632 Del Prado Blvd N Ste 301
Cape Coral, FL 33909-2278
Phone (239) 768-2111

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209003287ILMDNurse Practitioner
APRN11026698FLMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Island Coast Pediatrics PastSince Oct 15, 2023 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jennifer.hartman@34065646485508.direct.elationemr.com

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": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696809600000",
    "number": "1295729887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 DEL PRADO BLVD N STE 301",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339092278",
            "telephone_number": "239-768-2111",
            "fax_number": "239-482-4404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "632 DEL PRADO BLVD N STE 301",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339092278",
            "telephone_number": "239-768-2111",
            "fax_number": "239-482-4404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTMAN",
        "first_name": "JENNIFER",
        "middle_name": "B",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-09",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209003287",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "APRN11026698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2023; 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.