Individual provider Active NPI

Jessica Pease Gosnell, MD

  • Psychiatry Physician
  • Tampa, FL
National Provider Identifier
1548424310
Registry record updated Dec 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME107015 Issued in FL
Practice address
3515 E Fletcher Ave
Mdc14
Tampa, FL 33613-4702
Phone
(813) 974-8900
NPI assigned
Jul 11, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X ME107015 FL Primary

Addresses

Primary practice location

3515 E Fletcher Ave
Mdc14
Tampa, FL 33613-4702

Mailing address

3515 E Fletcher Ave
Mdc14
Tampa, FL 33613-4702
Phone (813) 974-8900

Other names 1

  • Jessica Ann Pease-Campbell Former name

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME107015FLMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1215734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449446400000",
    "number": "1548424310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3515 E FLETCHER AVE",
            "address_2": "MDC14",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336134702",
            "telephone_number": "813-974-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3515 E FLETCHER AVE",
            "address_2": "MDC14",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336134702",
            "telephone_number": "813-974-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOSNELL",
        "first_name": "JESSICA",
        "middle_name": "PEASE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-11",
        "last_updated": "2015-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME107015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "PEASE-CAMPBELL",
            "middle_name": "ANN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Dec 7, 2015; 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.