Individual provider Active NPI

Jadie Lindsey Heberlein, ARNP-C

  • Family Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1487163796
Registry record updated Jan 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9336763 Issued in FL
Practice address
5635 Hoover Blvd
Tampa, FL 33634-5300
Phone
(813) 289-0445
Fax
(813) 282-0107
NPI assigned
Sep 29, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN9336763 FL
Family Nurse Practitioner 363LF0000X ARNP9336763 FL Primary

Addresses

Primary practice location

5635 Hoover Blvd
Tampa, FL 33634-5300

Mailing address

5635 Hoover Blvd
Tampa, FL 33634-5300
Phone (813) 289-0445

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

LicenseStateTypeSpecialty
RN9336763FLMDRegistered Nurse
ARNP9336763FLMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1506643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516752000000",
    "number": "1487163796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5635 HOOVER BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336345300",
            "telephone_number": "813-289-0445",
            "fax_number": "813-282-0107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5635 HOOVER BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336345300",
            "telephone_number": "813-289-0445",
            "fax_number": "813-282-0107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEBERLEIN",
        "first_name": "JADIE",
        "middle_name": "LINDSEY",
        "credential": "ARNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-29",
        "last_updated": "2018-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9336763",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9336763",
            "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 24, 2018; 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.