Active NPI
Catherine Caroline Mbom
- Family Nurse Practitioner
- Tampa, FL
National Provider Identifier
1487118352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- APRN11000381
- Practice address
- 2810 W Waters Ave
Tampa, FL 33614-1853 - Phone
- (813) 935-5501
- NPI assigned
- Jan 25, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | APRN11000381 | FL | Primary |
Addresses
Primary practice location
2810 W Waters Ave
Tampa, FL 33614-1853
Mailing address
538 Rapid Falls Dr
Brandon, FL 33511-7548
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN11000381 | FL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tampa Bay Pulmonary Associates,P.a. | Past | Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/CHIHBA
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.
-
- Specialist
- Tampa, FL
- NPI 1013947282
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548374400000",
"number": "1487118352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "538 RAPID FALLS DR",
"city": "BRANDON",
"state": "FL",
"postal_code": "335117548"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2810 W WATERS AVE",
"city": "TAMPA",
"state": "FL",
"postal_code": "336141853",
"telephone_number": "813-935-5501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MBOM",
"first_name": "CATHERINE",
"middle_name": "CAROLINE",
"name_prefix": "Miss",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-25",
"last_updated": "2019-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "FL",
"license": "APRN11000381",
"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 Jan 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.