Individual provider Active NPI

Drina Geraldine Portman, DNP, APRN-BC

  • Adult Health Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1659362424
Registry record updated Jun 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APRN2621802 Issued in FL
Practice address
7406 Fullerton St
Jacksonville, FL 32256-3552
Phone
(305) 336-2711
Fax
(954) 920-9855
NPI assigned
Nov 2, 2005
Last updated
Jun 22, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X APRN2621802 FL Primary

Addresses

Primary practice location

7406 Fullerton St
Jacksonville, FL 32256-3552

Mailing address

7406 Fullerton St
Jacksonville, FL 32256-3552
Phone (305) 336-2711

Other identifiers 2

IdentifierTypeStateIssuer
302867400MedicaidFL
APRN2621802OtherFLFLORIDA BOARD OF NURSING

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN2621802FLMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592784000000",
    "number": "1659362424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7406 FULLERTON ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322563552",
            "telephone_number": "305-336-2711",
            "fax_number": "954-920-9855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7406 FULLERTON ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322563552",
            "telephone_number": "305-336-2711",
            "fax_number": "954-920-9855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTMAN",
        "first_name": "DRINA",
        "middle_name": "GERALDINE",
        "name_prefix": "Mrs.",
        "credential": "DNP, APRN-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-02",
        "last_updated": "2020-06-22",
        "certification_date": "2020-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN2621802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "302867400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BOARD OF NURSING",
            "identifier": "APRN2621802",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 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.