Active NPI
Sally Ann Freeman, A.R.N.P., C.P.N.P.
- Pediatric Nurse Practitioner
- Tampa, FL
National Provider Identifier
1487738787
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- ARNP2814692
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| ARNP2814692 | FL | MD | Psychiatric/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.