Individual provider Active NPI

Jacqueline Christine Higginbottom, ARNP

  • Family Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1376955856
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9308803 Issued in FL
Practice address
1 Tampa General Cir
Palliative Care Office
Tampa, FL 33606-3571
Phone
(813) 844-7000
Fax
(813) 844-1609
NPI assigned
Jun 2, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN9308803 FL
Registered Nurse 163W00000X RN1014133 DC
Family Nurse Practitioner 363LF0000X ARNP9308803 FL Primary

Addresses

Primary practice location

1 Tampa General Cir
Palliative Care Office
Tampa, FL 33606-3571

Mailing address

PO Box 917770
Orlando, FL 32891-0001
Phone (813) 974-2201

Other identifiers 1

IdentifierTypeStateIssuer
C24FLOtherFLBLUE CROSS BLUE SHIELD

Other names 1

  • Miss Jacqueline Christine Ross Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jhigginbottom11068@direct.tgh.org

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
I20180524000553 FL Practitioner - Nurse Practitioner 6608131503 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Medical Service Association IncGroup PAC ID 6800790221, 818 clinicians

Practice addresses (Care Compare)

3500 E Fletcher Ave
Suite 100
Tampa, FL 33613-4701
Phone (813) 821-8038

Hospital & facility affiliations

  • Tampa General Hospital Hospital, Tampa, FL, CCN 100128

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN1014133DCMDRegistered Nurse
RN9308803FLMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Service Association Inc CurrentSince Mar 20, 2018 Accepting new patients
University Medical Service Association Inc CurrentSince Mar 20, 2018 Accepting new patients
Tampa General Hospital Current Accepting new patients
University Medical Service Association Inc Current Accepting new patients

Locations

12902 Usf Magnolia Dr
Tampa, FL 33612
Phone (813) 745-2720

12901 Bruce B Downs Blvd
#19
Tampa, FL 33612
Phone (813) 844-4103

12901 Bruce B Downs Blvd
#62
Tampa, FL 33612

4202 E Fowler Ave
Stop SHS100
Tampa, FL 33620
Phone (813) 974-2331

3500 E Fletcher Ave
Ste 100
Tampa, FL 33613
Phone (813) 282-8520

Interoperability endpoints

  • Direct secure messaging: jhigginbottom11068@direct.tgh.org
  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1401667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1376955856",
    "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",
            "telephone_number": "813-974-2201",
            "fax_number": "813-974-4325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 TAMPA GENERAL CIR",
            "address_2": "PALLIATIVE CARE OFFICE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063571",
            "telephone_number": "813-844-7000",
            "fax_number": "813-844-1609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIGGINBOTTOM",
        "first_name": "JACQUELINE",
        "middle_name": "CHRISTINE",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-02",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9308803",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "DC",
            "license": "RN1014133",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9308803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "C24FL",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jhigginbottom11068@direct.tgh.org",
            "affiliation": "N",
            "address_1": "1 Tampa General Cir",
            "address_2": "Palliative Care Office",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336063571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "ROSS",
            "middle_name": "CHRISTINE",
            "prefix": "MISS",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.