Jacqueline Maria Niebles, M.D

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME66997 Issued in FL

Practice address

14499 N Dale Mabry Hwy
Suite 180-S
Tampa, FL 33618-2078

Phone

(813) 501-3710

Fax

(813) 513-9395

NPI assigned

Oct 11, 2005

Last updated

May 3, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jacqueline.niebles@childrensdoc.directbygreenway.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Childrens Doctor of Tampabay, Jacquelin Eniebles MD, PLLC

  • Pediatrics Physician
  • Tampa, FL
  • NPI 1386178739
  NPD (past) Authorized official

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493769600000",
    "number": "1356339568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1375 INDIAN TRL N",
            "address_2": "SUITE 180-S",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346832809",
            "telephone_number": "727-481-8075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14499 N DALE MABRY HWY",
            "address_2": "SUITE 180-S",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336182078",
            "telephone_number": "813-501-3710",
            "fax_number": "813-513-9395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEBLES",
        "first_name": "JACQUELINE",
        "middle_name": "MARIA",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-11",
        "last_updated": "2017-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME66997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "19311",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2238087",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIEL",
            "identifier": "26241",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHEASE",
            "identifier": "19311",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "212684",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "255357",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2840575003",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "376077400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Santo Nicosia, MD
• Nida Littlefield and Associates
• Vicki A Nidzgorski, DENTAL HYGIENIST
• Julia Mercer Niebauer, MD
• Niebles and Samter MDS P.a (The Kid's Doctor)
• Alena Niederlova, PT
• Colleen Niedzwiecki, MD
• Saleena Ruth Niehaus, D.P.M.
• Bethany L. Niell, MD
• Brett M Nielsen, DPM

• Pediatrics Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2017; 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.