Individual provider Active NPI

Vicki Cross, APRN

  • Gerontology Nurse Practitioner
  • St Petersburg, FL
National Provider Identifier
1346895000
Registry record updated Aug 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
11003558 Issued in FL
Practice address
1839 Central Ave
St Petersburg, FL 33713-8900
Phone
(727) 322-1054
NPI assigned
Aug 8, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 11003558 FL Primary

Addresses

Primary practice location

1839 Central Ave
St Petersburg, FL 33713-8900

Mailing address

127 23Rd Ave S
St Petersburg, FL 33705-3209
Phone (727) 639-1965

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
I20190906000418 FL Practitioner - Nurse Practitioner 8123357886 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11003558FLMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Health Care of Pinellas Inc. CurrentSince Aug 9, 2019 Accepting new patients
Professional Health Care of Pinellas LLC CurrentSince Aug 9, 2019 Accepting new patients

Locations

1839 Central Ave
St Petersburg, FL 33713
Phone (727) 322-1054

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EIJHAA

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.

NPI Registry JSON

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

{
    "created_epoch": "1565222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565222400000",
    "number": "1346895000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 23RD AVE S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337053209",
            "telephone_number": "727-639-1965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1839 CENTRAL AVE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337138900",
            "telephone_number": "727-322-1054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROSS",
        "first_name": "VICKI",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-08",
        "last_updated": "2019-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "11003558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.