Active NPI
Sandra L Stutzman, ARNP
- Acute Care Nurse Practitioner
- Tampa, FL
National Provider Identifier
1356381768
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- ARNP2507072
- Practice address
- 1105 E Kennedy Blvd
Suite 311
Tampa, FL 33602-3511 - Phone
- (813) 307-8015
- Fax
- (813) 276-2999
- NPI assigned
- Jun 7, 2006
- Last updated
- Feb 6, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | ARNP2507072 | FL | |
| Acute Care Nurse Practitioner | 363LA2100X | ARNP2507072 | FL | Primary |
Addresses
Primary practice location
1105 E Kennedy Blvd
Suite 311
Tampa, FL 33602-3511
Mailing address
1105 E Kennedy Blvd
Suite 311
Tampa, FL 33602-3511
Phone (813) 307-8015
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 305529900 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Acv Community Services LLC | Past | Accepting new patients | |
| Sergio H. Vallejo M. D. , P. a. | Nurse Practitioner | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Rural Health Clinic/Center
- Live Oak, FL
- NPI 1174630693
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1517875200000",
"number": "1356381768",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1105 E KENNEDY BLVD",
"address_2": "SUITE 311",
"city": "TAMPA",
"state": "FL",
"postal_code": "336023511",
"telephone_number": "813-307-8015",
"fax_number": "813-272-7116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1105 E KENNEDY BLVD",
"address_2": "SUITE 311",
"city": "TAMPA",
"state": "FL",
"postal_code": "336023511",
"telephone_number": "813-307-8015",
"fax_number": "813-276-2999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STUTZMAN",
"first_name": "SANDRA",
"middle_name": "L",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-07",
"last_updated": "2018-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "FL",
"license": "ARNP2507072",
"primary": false
},
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "FL",
"license": "ARNP2507072",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "305529900",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.