Individual provider Active NPI

Jennifer L Strom

  • Nurse Practitioner
  • Englewood, FL
National Provider Identifier
1528347911
Registry record updated Jan 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP9437042 Issued in FL
Practice address
2400 S McCall Rd Ste C
Englewood, FL 34224-5136
Phone
(941) 474-9314
Fax
(941) 473-9813
NPI assigned
Aug 16, 2011
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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704193128 MI
Gerontology Nurse Practitioner 363LG0600X 4704193128 MI
Nurse Practitioner 363L00000X ARNP9437042 FL Primary

Addresses

Primary practice location

2400 S McCall Rd Ste C
Englewood, FL 34224-5136

Mailing address

3434 Hancock Bridge Pkwy Ste 301
North Fort Myers, FL 33903-7099
Phone (877) 856-3774

Other identifiers 1

IdentifierTypeStateIssuer
9WIU1OtherFLBCBS

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1313452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516752000000",
    "number": "1528347911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3434 HANCOCK BRIDGE PKWY STE 301",
            "city": "NORTH FORT MYERS",
            "state": "FL",
            "postal_code": "339037099",
            "telephone_number": "877-856-3774",
            "fax_number": "239-599-2612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 S MCCALL RD STE C",
            "city": "ENGLEWOOD",
            "state": "FL",
            "postal_code": "342245136",
            "telephone_number": "941-474-9314",
            "fax_number": "941-473-9813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STROM",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-16",
        "last_updated": "2018-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704193128",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MI",
            "license": "4704193128",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9437042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "9WIU1",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, 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.