Individual provider Active NPI

Jenny Kidd Nickless, DNP, ARNP

  • Family Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1326916875
Registry record updated Mar 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11044599 Issued in FL
Practice address
8701 Maitland Summit Blvd
Orlando, FL 32810-5915
Phone
(407) 200-2759
NPI assigned
Oct 27, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN9297117 FL
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X APRN11044599 FL Primary

Addresses

Primary practice location

8701 Maitland Summit Blvd
Orlando, FL 32810-5915

Mailing address

8701 Maitland Summit Blvd
Orlando, FL 32810-5915
Phone (407) 200-2759

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
I20260328000223 FL Practitioner - Nurse Practitioner 6103301072 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
Telehealth
Offers telehealth services
Group practices
Adventhealth Primary Care Network IncGroup PAC ID 1557722410, 428 clinicians

Practice addresses (Care Compare)

661 E Altamonte Dr
Suite 115
Altamonte Springs, FL 32701-5102
Phone (407) 831-4040

8701 Maitland Summit Blvd
Orlando, FL 32810-5915
Phone (407) 200-2759

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN11044599FLMDFamily Nurse Practitioner
RN9297117FLMDFamily Nurse Practitioner

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1761523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773878400000",
    "number": "1326916875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8701 MAITLAND SUMMIT BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328105915",
            "telephone_number": "407-200-2759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8701 MAITLAND SUMMIT BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328105915",
            "telephone_number": "407-200-2759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKLESS",
        "first_name": "JENNY",
        "middle_name": "KIDD",
        "credential": "DNP, ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-27",
        "last_updated": "2026-03-19",
        "certification_date": "2026-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "RN9297117",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11044599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.