Organization Active NPI

Vip Primary Care Services

  • Family Nurse Practitioner
  • Bartow, FL
National Provider Identifier
1508542424
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
VIP PRIMARY CARE SERVICES
Practice address
1482 N. Wilson Ave
Bartow, FL 33830
Phone
(863) 440-8770
Fax
(863) 656-3401
NPI assigned
Jun 26, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2025

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

Authorized official

Name
Inga Jennings, APRNNPI 1427602820
Title
Provider
Phone
(863) 440-8770

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

1482 N. Wilson Ave
Bartow, FL 33830

Mailing address

2958 Warfield Drive
Bartow, FL 33830
Phone (863) 440-8770

Other identifiers 1

IdentifierTypeStateIssuer
1428762820OtherFLNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230928000635 FL Part B Supplier - Clinic/Group Practice 1254785082 Receives reassigned benefits from 1 practitioner
Practice locations: Bartow, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2299612Vip Primary Care Services LLC1482 N Wilson Ave, Bartow, FL 33830Certificate of waiverFeb 22, 2028

National Provider Directory

National Provider Directory

Locations

1482 N Wilson Ave
Bartow, FL 33830
Phone (863) 323-2136

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1687737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755561600000",
    "number": "1508542424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2958 WARFIELD DRIVE",
            "city": "BARTOW",
            "state": "FL",
            "postal_code": "33830",
            "telephone_number": "863-440-8770",
            "fax_number": "863-656-3401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1482 N. WILSON AVE",
            "city": "BARTOW",
            "state": "FL",
            "postal_code": "33830",
            "telephone_number": "863-440-8770",
            "fax_number": "863-656-3401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIP PRIMARY CARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-26",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A",
        "authorized_official_last_name": "JENNINGS",
        "authorized_official_first_name": "INGA",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "863-440-8770",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1428762820",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bartow, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.