NPIMap

Organization Active NPI

St Josephs Hopsital

  • Neonatal Nurse Practitioner
  • Lutz, FL
National Provider Identifier
1457623233
Registry record updated Mar 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
Legal business name
ST JOSEPHS HOPSITAL
Practice address
4211 Van Dyke Rd
Lutz, FL 33558-8002
Phone
(813) 443-2010
NPI assigned
Feb 8, 2012
Last updated
Mar 4, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2020

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

Authorized official

Name
Ms. Lynda Gorken
Title
VP
Phone
(727) 281-9390

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X FL Primary

Addresses

Primary practice location

4211 Van Dyke Rd
Lutz, FL 33558-8002

Mailing address

2995 Drew St FL 2
Clearwater, FL 33759-3012
Phone (727) 281-9390

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidFL

Other names 1

  • SJN Neonates Other name

National Provider Directory

National Provider Directory
Tax ID family
St Joseph's Hospital Inc13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1328659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583280000000",
    "number": "1457623233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2995 DREW ST FL 2",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337593012",
            "telephone_number": "727-281-9390",
            "fax_number": "813-635-2613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4211 VAN DYKE RD",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335588002",
            "telephone_number": "813-443-2010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JOSEPHS HOPSITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-08",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A",
        "authorized_official_last_name": "GORKEN",
        "authorized_official_first_name": "LYNDA",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "727-281-9390",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SJN Neonates",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "SJN Neonates",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lutz, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2020; 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.