Individual provider Active NPI

Donna Lynn Bledsoe, ARNP

  • Pediatric Nurse Practitioner
  • St Petersburg, FL
National Provider Identifier
1558745448
Registry record updated Nov 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
ARNP9165354 Issued in FL
Practice address
601 5TH St S
St Petersburg, FL 33701-4804
Phone
(727) 767-8480
NPI assigned
Jul 10, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2022

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 ARNP9165354 FL
Pediatric Nurse Practitioner 363LP0200X ARNP9165354 FL Primary

Addresses

Primary practice location

601 5TH St S
St Petersburg, FL 33701-4804

Mailing address

1959 Overview Dr
New Port Richey, FL 34655-4106
Phone (727) 235-8654

Other practice location 1

1219 E Tarpon Ave
Tarpon Springs, FL 34689-5441
Phone (727) 934-4477

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
I20171025000681 FL Practitioner - Nurse Practitioner 7911273610 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9165354FLMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Physician Services, Inc. CurrentSince Sep 1, 2017 Accepting new patients

Locations

601 5th St S
Ste 5
St Petersburg, FL 33701
Phone (727) 727-4429

501 6th Ave S
St Petersburg, FL 33701
Phone (727) 344-6060

601 5th St S
St Petersburg, FL 33701
Phone (727) 767-3333

Interoperability endpoints

  • Direct secure messaging: dkeyes733917@direct.hopkinsmedicine.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1436486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1558745448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1959 OVERVIEW DR",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346554106",
            "telephone_number": "727-235-8654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 5TH ST S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014804",
            "telephone_number": "727-767-8480"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1219 E Tarpon Ave",
            "address_purpose": "LOCATION",
            "city": "Tarpon Springs",
            "state": "FL",
            "postal_code": "346895441",
            "country_code": "US",
            "telephone_number": "727-934-4477",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLEDSOE",
        "first_name": "DONNA",
        "middle_name": "LYNN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-10",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9165354",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "ARNP9165354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.