Individual provider Active NPI

Jermece Watts, APRN

  • Family Nurse Practitioner
  • Minnetonka, MN
National Provider Identifier
1376182485
Registry record updated Oct 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11004643 Issued in FL
Practice address
9900 Bren Rd E
Minnetonka, MN 55343-9664
Phone
(727) 557-5655
NPI assigned
Jan 6, 2020
Last updated
Oct 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11004643 FL Primary

Addresses

Primary practice location

9900 Bren Rd E
Minnetonka, MN 55343-9664

Mailing address

6101 Dr Martin Luther King Jr St N
St Petersburg, FL 33703-1141
Phone (727) 557-5655

Other practice location 1

6101 Dr Martin Luther King Jr St N
St Petersburg, FL 33703-1141
Phone (727) 572-6200

Other practice location 2

6101 Dr Martin Luther King Jr St N
St Petersburg, FL 33703-1141
Phone (727) 572-6200

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
I20200411000565 FL Practitioner - Nurse Practitioner 8527497684 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11004643FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Consultants of Florida, Inc CurrentSince May 11, 2020 Accepting new patients
Mana Health Partners PA CurrentSince Dec 1, 2023 Accepting new patients
Inpatient Consultants of Florida Inc CurrentSince May 11, 2020 Accepting new patients
Careconnectmd Florida P.a. CurrentSince Aug 1, 2024 Accepting new patients

Locations

3090 Bristol St
Ste 200
Costa Mesa, CA 92626
Phone (714) 992-1182

105 15th St E
Bradenton, FL 34208
Phone (941) 747-8681

1507 S Tuttle Ave
Sarasota, FL 34239
Phone (941) 366-0336

3030 W Bearss Ave
Tampa, FL 33618
Phone (813) 932-2222

338 Whitesville Rd
Ste 103
Jackson, NJ 08527

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1578268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697932800000",
    "number": "1376182485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 DR MARTIN LUTHER KING JR ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337031141",
            "telephone_number": "727-557-5655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 BREN RD E",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553439664",
            "telephone_number": "727-557-5655"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6101 Dr Martin Luther King Jr St N",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337031141",
            "country_code": "US",
            "telephone_number": "727-572-6200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6101 Dr Martin Luther King Jr St N",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337031141",
            "country_code": "US",
            "telephone_number": "727-572-6200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATTS",
        "first_name": "JERMECE",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-06",
        "last_updated": "2023-10-22",
        "certification_date": "2023-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11004643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minnetonka, MN

Sources for this page

Verify at the official NPI Registry.