Individual provider Active NPI

Julie Guadron

  • Family Nurse Practitioner
  • St Petersburg, FL
National Provider Identifier
1538829098
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11017126 Issued in FL
Practice address
4626 14TH St N
St Petersburg, FL 33703-3502
Phone
(727) 422-1438
NPI assigned
Dec 26, 2021
Last updated
Nov 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN11017126 FL
Family Nurse Practitioner 363LF0000X APRN11017126 FL Primary

Addresses

Primary practice location

4626 14TH St N
St Petersburg, FL 33703-3502

Mailing address

4626 14TH St N
St Petersburg, FL 33703-3502

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220516001265 FL Practitioner - Nurse Practitioner 3971980889 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State Wide Dermatology 'LLC'Group PAC ID 1052531035, 5 clinicians

Practice addresses (Care Compare)

17121 Rainbow Ter
Odessa, FL 33556-2107
Phone (813) 749-0907

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11017126FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
State Wide Dermatology LLC CurrentSince Apr 4, 2022 Accepting new patients

Organizations & group practices 1

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": "1640476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1538829098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4626 14TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337033502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4626 14TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337033502",
            "telephone_number": "727-422-1438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUADRON",
        "first_name": "JULIE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-26",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11017126",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11017126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.