Individual provider Active NPI

Jennifer L Liska Conner, APRN

  • Gerontology Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1336284660
Registry record updated Nov 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
11002903 Issued in FL
Practice address
1507 S Hiawassee Rd Ste 107
Orlando, FL 32835-5706
Phone
(407) 445-9545
Fax
(407) 445-9545
NPI assigned
Feb 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 11002903 FL Primary
Gerontology Registered Nurse 163WG0600X 2279 WI

Addresses

Primary practice location

1507 S Hiawassee Rd Ste 107
Orlando, FL 32835-5706

Mailing address

1507 S Hiawassee Rd Ste 107
Orlando, FL 32835-5706
Phone (407) 445-9545

Other identifiers 1

IdentifierTypeStateIssuer
41252100MedicaidWI

Other names 1

  • Jennifer L Liska Former name

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
I20191212002727 FL Practitioner - Nurse Practitioner 9032162334 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Med-Psych Consultants LLCGroup PAC ID 5799115713, 20 clinicians
Orlando Inpatient Medicine PAGroup PAC ID 0749598316, 54 clinicians
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Practice addresses (Care Compare)

1507 S Hiawassee Rd
Suite 206
Orlando, FL 32835-5719
Phone 4074459545222

601 E Rollins St
Orlando, FL 32803-1248
Phone (407) 445-9545

8066 B Market St
Wilmington, NC 28411-9384
Phone (910) 686-8485

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2279WIMDDentist
11002903FLMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Med-Psych Consultants LLC CurrentSince Jan 27, 2020 Accepting new patients
Orlando Inpatient Medicine, PA CurrentSince Nov 6, 2019 Accepting new patients

Locations

1507 S Hiawassee Rd
Ste 107
Orlando, FL 32835
Phone (407) 445-9545

1507 S Hiawassee Rd
Ste 206
Orlando, FL 32835
Phone (407) 445-9545

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

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.

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": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574035200000",
    "number": "1336284660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 S HIAWASSEE RD STE 107",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328355706",
            "telephone_number": "407-445-9545",
            "fax_number": "407-299-6160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 S HIAWASSEE RD STE 107",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328355706",
            "telephone_number": "407-445-9545",
            "fax_number": "407-445-9545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISKA CONNER",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2019-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "11002903",
            "primary": true
        },
        {
            "code": "163WG0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gerontology",
            "state": "WI",
            "license": "2279",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41252100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "LISKA",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.