Mary Jane Concengco, A.R.N.P.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

ARNP9180792 Issued in FL

Practice address

1115 E. Ridgewood Street
Orlando, FL 32803

Phone

(407) 841-1100

Fax

(407) 650-0262

NPI assigned

May 31, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1338422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363824000000",
    "number": "1417218942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 E. RIDGEWOOD STREET",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32803",
            "telephone_number": "407-841-1100",
            "fax_number": "407-650-0262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 E. RIDGEWOOD STREET",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32803",
            "telephone_number": "407-841-1100",
            "fax_number": "407-650-0262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONCENGCO",
        "first_name": "MARY",
        "middle_name": "JANE",
        "credential": "A.R.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-31",
        "last_updated": "2013-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "585935",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704229396",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9180792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Comrie
• Jessica Conaway
• Nicholas Joseph Conboy, CAA
• Andrew Joseph Concannon
• Tara Hulse Concelman, B.C.B.A.
• Tristyn Jordan Reandelar Concengco
• Yazmin Concepcion Orozco
• Gina Marie Concepcion
• Concert Health Flordia, LLC
• Ana Vivian Concha Chagime, MD

• Nurse Practitioner in Orlando, FL
• Providers in Orlando, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.