Active NPI
Jessica Bandhu, AGPCNP-BC
- Adult Health Nurse Practitioner
- Tampa, FL
National Provider Identifier
1740954692
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- APRN11012257
- Practice address
- 3321 Glen Meadow CT
Tampa, FL 33614-2796 - Phone
- (217) 851-3483
- NPI assigned
- Aug 4, 2021
- Last updated
- Jun 15, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | APRN11012257 | FL | Primary |
Addresses
Primary practice location
3321 Glen Meadow CT
Tampa, FL 33614-2796
Mailing address
3321 Glen Meadow CT
Tampa, FL 33614-2796
Phone (217) 851-3483
Other names 1
- Jessica Costello
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN11012257 | FL | MD | Adult Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1628035200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718409600000",
"number": "1740954692",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3321 GLEN MEADOW CT",
"city": "TAMPA",
"state": "FL",
"postal_code": "336142796",
"telephone_number": "217-851-3483"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3321 GLEN MEADOW CT",
"city": "TAMPA",
"state": "FL",
"postal_code": "336142796",
"telephone_number": "217-851-3483"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANDHU",
"first_name": "JESSICA",
"credential": "AGPCNP-BC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-08-04",
"last_updated": "2024-06-15",
"certification_date": "2024-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "FL",
"license": "APRN11012257",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JESSICA",
"last_name": "COSTELLO",
"code": "1",
"type": "Former Name"
}
]
}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 Jun 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.