Individual provider Active NPI

Justine Kelderhouse, A.R.N.P.

  • Pediatric Nurse Practitioner
  • Oakland Park, FL
National Provider Identifier
1528230950
Registry record updated Jun 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
ARNP 3059102 Issued in FL
Practice address
5333 N Dixie Hwy
Suite 106
Oakland Park, FL 33334-3414
Phone
(954) 771-4747
NPI assigned
Mar 26, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X ARNP 3059102 FL Primary

Addresses

Primary practice location

5333 N Dixie Hwy
Suite 106
Oakland Park, FL 33334-3414

Mailing address

2279 NW 75TH Ave
Margate, FL 33063-7936
Phone (954) 971-6184

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
ARNP 3059102FLMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Taslimi & Mirza, M.D., P.a. Past Accepting new patients
Taslimi & Mirza, M.D., P.a. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: justinekelderhouse@cmap-fl.direct.office.nextgen.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1206489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307145600000",
    "number": "1528230950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2279 NW 75TH AVE",
            "city": "MARGATE",
            "state": "FL",
            "postal_code": "330637936",
            "telephone_number": "954-971-6184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5333 N DIXIE HWY",
            "address_2": "SUITE 106",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333343414",
            "telephone_number": "954-771-4747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELDERHOUSE",
        "first_name": "JUSTINE",
        "name_prefix": "Ms.",
        "credential": "A.R.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-26",
        "last_updated": "2011-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "ARNP 3059102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 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.