Individual provider Active NPI

Jasmin Pullappally, ARNP

  • Family Nurse Practitioner
  • Valrico, FL
National Provider Identifier
1396296174
Registry record updated Feb 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9271387 Issued in FL
Practice address
2602 Queen Alberta Dr
Valrico, FL 33596-6526
Phone
(727) 252-9849
NPI assigned
Oct 17, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X OS7173 FL
Family Nurse Practitioner 363LF0000X 9271387 FL Primary

Addresses

Primary practice location

2602 Queen Alberta Dr
Valrico, FL 33596-6526

Mailing address

2602 Queen Alberta Dr
Valrico, FL 33596-6526
Phone (727) 252-9849

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
I20240125002277 FL Practitioner - Nurse Practitioner 4183077233

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS7173FLMDEmergency Medicine Physician
9271387FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sunrise Urgent Care Associates LLC Emergency Medicine PastSince Apr 6, 2023 Accepting new patients

Organizations & group practices 1

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": "1476662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1396296174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2602 QUEEN ALBERTA DR",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "335966526",
            "telephone_number": "727-252-9849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2602 QUEEN ALBERTA DR",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "335966526",
            "telephone_number": "727-252-9849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULLAPPALLY",
        "first_name": "JASMIN",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-17",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "OS7173",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9271387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valrico, FL

Sources for this page

Verify at the official NPI Registry.