Active NPI
Kerri Lynn Telibasa
- Critical Care Pediatric Nurse Practitioner
- Orlando, FL
National Provider Identifier
1699398461
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Pediatric Nurse Practitioner
- License
- 11007244
- Practice address
- 92 W Miller St
Orlando, FL 32806-2032 - Phone
- (407) 267-3484
- NPI assigned
- May 27, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Pediatric Nurse Practitioner | 363LP0222X | 11007244 | FL | Primary |
Addresses
Primary practice location
92 W Miller St
Orlando, FL 32806-2032
Mailing address
92 W Miller St
Orlando, FL 32806-2032
Phone (407) 267-3484
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
| License | State | Type | Specialty |
|---|---|---|---|
| 11007244 | FL | MD | Critical Care Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1590537600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590537600000",
"number": "1699398461",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "92 W MILLER ST",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328062032",
"telephone_number": "407-267-3484"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "92 W MILLER ST",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328062032",
"telephone_number": "407-267-3484"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TELIBASA",
"first_name": "KERRI",
"middle_name": "LYNN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-27",
"last_updated": "2020-05-27",
"certification_date": "2020-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0222X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics, Critical Care",
"state": "FL",
"license": "11007244",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 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.