Individual provider Active NPI

Sally Ann Freeman, A.R.N.P., C.P.N.P.

  • Pediatric Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1487738787
Registry record updated Aug 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
ARNP2814692 Issued in FL
Practice address
3191 Clay Mangum LN
Tampa, FL 33618-2501
Phone
(813) 264-3807
Fax
(813) 264-8931
NPI assigned
Oct 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP2814692 FL
Pediatric Nurse Practitioner 363LP0200X ARNP2814692 FL Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X ARNP2814692 FL

Addresses

Primary practice location

3191 Clay Mangum LN
Tampa, FL 33618-2501

Mailing address

18631 Le Dauphine PL
Lutz, FL 33558-2886
Phone (813) 789-3642

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
Credentials
Certified Pediatric Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP2814692FLMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313539200000",
    "number": "1487738787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18631 LE DAUPHINE PL",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335582886",
            "telephone_number": "813-789-3642",
            "fax_number": "813-932-0667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3191 CLAY MANGUM LN",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336182501",
            "telephone_number": "813-264-3807",
            "fax_number": "813-264-8931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "SALLY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "A.R.N.P., C.P.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2011-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP2814692",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "ARNP2814692",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "ARNP2814692",
            "primary": false
        }
    ],
    "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 Aug 17, 2011; 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.