Jackie N Marcelin, DNP, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

ARNP9247888 Issued in FL

Practice address

1105 E Kennedy Blvd
Tampa, FL 33602-3511

Phone

(813) 307-8064

Fax

(813) 272-7116

NPI assigned

Feb 14, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Networks

• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: jmarcelin166808@direct.tgh.org
• FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

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.

• Tampa General Hospital

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1124558929
  NPD

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1346383122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 917770",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328910001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 E KENNEDY BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336023511",
            "telephone_number": "813-307-8064",
            "fax_number": "813-272-7116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCELIN",
        "first_name": "JACKIE",
        "middle_name": "N",
        "credential": "DNP, APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-14",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9247888",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "Y0JU9",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "308837500",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmarcelin166808@direct.tgh.org",
            "affiliation": "N",
            "address_1": "1105 E Kennedy Blvd",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336023511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Abraham Samuel Marcadis, MD
• Rebecca Sarah Marcadis, AU.D
• Soraya Marcano Castillo
• Frankie Annette Marcano, MSW, LMSW
• Chantal K Marceau, LMT
• Serlena R Marcelle
• Jean Marcellus
• Jorge Enrique Marcet, M.D.
• Mary Ann Marchand, LMT
• Kimberly A Marchant, ARNP

• Family Nurse Practitioner in Tampa, FL
• Providers in Tampa, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2021; 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.