St.Pete Nurse Practitioner, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

ST.PETE NURSE PRACTITIONER, LLC

Practice address

33 4TH St N Ste 202
Saint Petersburg, FL 33701-3806

Phone

(727) 686-8284

NPI assigned

May 9, 2022

Last updated

May 9, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jessica Caraballo, ARNPNPI 1437649100

Title

President

Phone

(727) 686-8284

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jessica Ann Caraballo, ARNP

  • Family Nurse Practitioner
  • St Petersburg, FL
  • NPI 1437649100
  Authorized official Same address or phone

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

{
    "created_epoch": "1652054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652054400000",
    "number": "1720724297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4670 CHANCELLOR ST NE",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337034345",
            "telephone_number": "727-686-8284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 4TH ST N STE 202",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337013806",
            "telephone_number": "727-686-8284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST.PETE NURSE PRACTITIONER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-09",
        "last_updated": "2022-05-09",
        "certification_date": "2022-05-09",
        "status": "A",
        "authorized_official_last_name": "CARABALLO",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "727-686-8284",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1437649100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• St. Petersburg Operator LLC (Brentwood Senior Living at St. Pete)
• St. Petersburg Outpatient Surgery Center, LLC (St. Petersburg Eye Surgery Center)
• St. Petersburg Primary Care Associates
• St. Petersburg Surgical Specialist
• St. Petersburg Woman's Health Center
• St.Petersburg Alf Management, LLC (Bayou Palms Assisted Living and Memory Care)
• Stabilityx Physical Therapy, LLC
• Christina Stabler
• Stacey Stafford
• Lucie Marie Stagg, DPT

• Primary Care Clinic/Center in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.