Individual provider Active NPI

Jennifer Vacco

  • Specialist
  • Tarpon Springs, FL
National Provider Identifier
1669921359
Registry record updated Sep 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA50809 Issued in FL
Practice address
612 E. Spruce Street
Tarpon Springs, FL 34689
Phone
(727) 580-0131
NPI assigned
Sep 23, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA50809 FL Primary

Addresses

Primary practice location

612 E. Spruce Street
Tarpon Springs, FL 34689

Mailing address

612 E. Spruce Street
Tarpon Springs, FL 34689
Phone (727) 580-0131

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MA50809FLMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1474588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474588800000",
    "number": "1669921359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 E. SPRUCE STREET",
            "city": "TARPON SPRINGS",
            "state": "FL",
            "postal_code": "34689",
            "telephone_number": "727-580-0131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 E. SPRUCE STREET",
            "city": "TARPON SPRINGS",
            "state": "FL",
            "postal_code": "34689",
            "telephone_number": "727-580-0131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VACCO",
        "first_name": "JENNIFER",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-23",
        "last_updated": "2016-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "MA50809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarpon Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2016; 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.