Jill Logothetis, APRN, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

R881494 Issued in MS

Practice address

1530 Airport Blvd
Pensacola, FL 32504-8616

Phone

(850) 474-4777

NPI assigned

May 7, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Pediatric Nurse Practitioner

State licenses

Practice roles

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.

• The Wolff Center for Child & Adolescent Health

  • Pediatrics Physician
  • Pensacola, FL
  • NPI 1104910702
  NPD (past)

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

{
    "created_epoch": "1430956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578960000000",
    "number": "1558749796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 AIRPORT BLVD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048616",
            "telephone_number": "850-474-4777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 AIRPORT BLVD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048616",
            "telephone_number": "850-474-4777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGOTHETIS",
        "first_name": "JILL",
        "credential": "APRN, CPNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-07",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MS",
            "license": "R881494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Breann Locklin, RMHCI
• Derek Lodico, DO
• Gregory Mark Loftis, MD
• Carlton Joshua Logan, ATC
• Edwin Logan, PT, DPT
• Crystal L Logsdon, ARNP
• Suman Lohana, M.D.
• Sharon Lee Lojun, MD
• Emili Lollar, RBT
• Rachelle S Lombardo, PTA

• Pediatric Nurse Practitioner in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Pediatric Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2020; 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.