Active NPI
Pi: Prevention and Intervention Wound Care and Dermatological Services
- Nursing Care Agency
- Tampa, FL
National Provider Identifier
1396313110
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Care Agency
- Legal business name
- PI: PREVENTION AND INTERVENTION WOUND CARE AND DERMATOLOGICAL SERVICES
- Practice address
- 10420 McKinley Dr Apt 9312
Tampa, FL 33612-6448 - Phone
- (813) 340-5499
- NPI assigned
- Jun 17, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Rhonda Gary Jackson, ARNP-C
- Title
- Owner
- Phone
- (813) 340-5499
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Care Agency | 251J00000X | Primary |
Addresses
Primary practice location
10420 McKinley Dr Apt 9312
Tampa, FL 33612-6448
Mailing address
10420 McKinley Dr Apt 9312
Tampa, FL 33612-6448
Phone (813) 340-5499
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210810001879 | FL | Part B Supplier - Clinic/Group Practice | 9830593086 |
Receives reassigned benefits from 7 practitioners Practice locations: Tampa, FL |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 7
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623888000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1623888000000",
"number": "1396313110",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10420 MCKINLEY DR APT 9312",
"city": "TAMPA",
"state": "FL",
"postal_code": "336126448",
"telephone_number": "813-340-5499"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10420 MCKINLEY DR APT 9312",
"city": "TAMPA",
"state": "FL",
"postal_code": "336126448",
"telephone_number": "813-340-5499"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PI: PREVENTION AND INTERVENTION WOUND CARE AND DERMATOLOGICAL SERVICES",
"organizational_subpart": "NO",
"enumeration_date": "2021-06-17",
"last_updated": "2021-06-17",
"certification_date": "2021-06-17",
"status": "A",
"authorized_official_last_name": "JACKSON",
"authorized_official_first_name": "RHONDA",
"authorized_official_middle_name": "GARY",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "813-340-5499",
"authorized_official_name_prefix": "Ms.",
"authorized_official_credential": "ARNP-C"
},
"taxonomies": [
{
"code": "251J00000X",
"taxonomy_group": "",
"desc": "Nursing Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"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 Jun 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.