Individual provider Active NPI

Jennifer Hyo Chong Millett, ARNP

  • Pediatric Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1295934180
Registry record updated Aug 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
ARNP9220452 Issued in FL
Practice address
3003 W. Martin Luther King Blvd
Mab 3Rd Floor
Tampa, FL 33607
Phone
(813) 870-4438
Fax
(813) 870-4153
NPI assigned
Jul 12, 2007
Last updated
Aug 29, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X ARNP9220452 FL Primary

Addresses

Primary practice location

3003 W. Martin Luther King Blvd
Mab 3Rd Floor
Tampa, FL 33607

Mailing address

3003 W Martin Luther King Blvd
Tampa, FL 33607
Phone (813) 870-4438

Other identifiers 1

IdentifierTypeStateIssuer
ARNP9220452OtherFLARNP LICENSE

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
ARNP9220452FLMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Pediatric Associates LLC Past Accepting new patients
Pediatrics Gastroenterology & Nutrition of Tampa Bay PA Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314576000000",
    "number": "1295934180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 W MARTIN LUTHER KING BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33607",
            "telephone_number": "813-870-4438",
            "fax_number": "813-870-4153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3003 W. MARTIN LUTHER KING BLVD",
            "address_2": "MAB 3RD FLOOR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33607",
            "telephone_number": "813-870-4438",
            "fax_number": "813-870-4153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLETT",
        "first_name": "JENNIFER",
        "middle_name": "HYO CHONG",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-12",
        "last_updated": "2011-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "ARNP9220452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARNP LICENSE",
            "identifier": "ARNP9220452",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2011; 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.