Organization Active NPI

Vonetta Nicole Psychiatry

  • Psychiatric/Mental Health Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1720799471
Registry record updated Jul 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
VONETTA NICOLE PSYCHIATRY
Practice address
1345 N Falkenburg Rd
Tampa, FL 33619-0945
Phone
(813) 388-8189
Fax
(813) 537-8718
NPI assigned
Dec 13, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2023

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

Authorized official

Name
Vonetta Nicole Erskine, PMHNP-BCNPI 1770256174
Title
Owner/Ceo
Phone
(772) 708-9728

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

1345 N Falkenburg Rd
Tampa, FL 33619-0945

Mailing address

1345 N Falkenburg Rd
Tampa, FL 33619-0945
Phone (813) 388-8189

Other practice location 1

5004 Wabash Pl
Riverview, FL 33578-4123
Phone (772) 708-9728

Other identifiers 1

IdentifierTypeStateIssuer
111656100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230209001408 FL Part B Supplier - Clinic/Group Practice 3577935063 Receives reassigned benefits from 1 practitioner
Practice locations: Tampa, FL

National Provider Directory

National Provider Directory

Locations

1345 N Falkenburg Rd
Tampa, FL 33619
Phone (386) 703-9084

100 S Ashley Dr
Ste 6001624
Tampa, FL 33602

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1670889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689292800000",
    "number": "1720799471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 N FALKENBURG RD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336190945",
            "telephone_number": "813-388-8189",
            "fax_number": "813-537-8718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 N FALKENBURG RD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336190945",
            "telephone_number": "813-388-8189",
            "fax_number": "813-537-8718"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5004 Wabash Pl",
            "address_purpose": "LOCATION",
            "city": "Riverview",
            "state": "FL",
            "postal_code": "335784123",
            "country_code": "US",
            "telephone_number": "772-708-9728",
            "fax_number": "813-537-8718",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VONETTA NICOLE PSYCHIATRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-13",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A",
        "authorized_official_last_name": "ERSKINE",
        "authorized_official_first_name": "VONETTA",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "772-708-9728",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111656100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.