Individual provider Active NPI

Jamie Michelle Stickler, APRN, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Bartow, FL
National Provider Identifier
1326789488
Registry record updated Jul 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
110016868 Issued in FL
Practice address
1239 E Main St
Bartow, FL 33830
Phone
(844) 968-9355
NPI assigned
Apr 5, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 110016868 FL Primary

Addresses

Primary practice location

1239 E Main St
Bartow, FL 33830

Mailing address

470 Citi Ctr St # 1116
Winter Haven, FL 33880-3425
Phone (844) 968-9355

Other names 1

  • Jamie Michelle Rotter Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
110016868FLMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656806400000",
    "number": "1326789488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "470 CITI CTR ST # 1116",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338803425",
            "telephone_number": "844-968-9355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1239 E MAIN ST",
            "city": "BARTOW",
            "state": "FL",
            "postal_code": "33830",
            "telephone_number": "844-968-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STICKLER",
        "first_name": "JAMIE",
        "middle_name": "MICHELLE",
        "credential": "APRN, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-05",
        "last_updated": "2022-07-03",
        "certification_date": "2022-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "110016868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAMIE",
            "last_name": "ROTTER",
            "middle_name": "MICHELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bartow, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2022; 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.