Individual provider Active NPI

Linda Sue Wardlaw

  • Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1457045809
Registry record updated Mar 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11026757 Issued in FL
Practice address
4003 S West Shore Blvd Apt 3406
Tampa, FL 33611-1035
Phone
(813) 788-8160
NPI assigned
Jun 7, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11026757 FL
Nurse Practitioner 363L00000X APRN11026757 FL Primary

Addresses

Primary practice location

4003 S West Shore Blvd Apt 3406
Tampa, FL 33611-1035

Mailing address

4003 S West Shore Blvd
Tampa, FL 33611-1046
Phone (813) 788-8160

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
I20230821000972 FL Practitioner - Nurse Practitioner 6901268176 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Accountable Inpatient MedicineGroup PAC ID 5597090274, 51 clinicians

Practice addresses (Care Compare)

8130 Lakewood Main St
Suite 103
Lakewood Ranch, FL 34202-5068

Hospital & facility affiliations

  • Sarasota Memorial Hospital Hospital, Sarasota, FL, CCN 100087
  • Lakewood Ranch Medical Center Hospital, Bradenton, FL, CCN 100299

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Accountable Inpatient Medicine CurrentSince Feb 5, 2025 Accepting new patients

Locations

8130 Lakewood Main St
Ste 103
Lakewood Ranch, FL 34202
Phone (918) 289-7085

8433 Enterprise Cir
Ste 100
Lakewood Ranch, FL 34202
Phone (941) 499-2700

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.

Hospital & facility affiliations 2

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": "1686096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1457045809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4003 S WEST SHORE BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336111046",
            "telephone_number": "813-788-8160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4003 S WEST SHORE BLVD APT 3406",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336111035",
            "telephone_number": "813-788-8160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARDLAW",
        "first_name": "LINDA",
        "middle_name": "SUE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-07",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11026757",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11026757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.