Individual provider Active NPI

Amy Flannigan Dittmer, ARNP

  • Pediatric Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1750768123
Registry record updated May 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
ARNP3238652 Issued in FL
Practice address
12502 Usf Pine Dr
Tampa, FL 33612-9411
Phone
(813) 975-7130
Fax
(813) 975-7129
NPI assigned
May 5, 2015
Last updated
May 5, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X ARNP3238652 FL Primary

Addresses

Primary practice location

12502 Usf Pine Dr
Tampa, FL 33612-9411

Mailing address

5805 Schooner Way
Tampa, FL 33615-3638
Phone (813) 554-8502

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
ARNP3238652FLMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1430784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430784000000",
    "number": "1750768123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5805 SCHOONER WAY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336153638",
            "telephone_number": "813-554-8502",
            "fax_number": "813-554-8596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12502 USF PINE DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336129411",
            "telephone_number": "813-975-7130",
            "fax_number": "813-975-7129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DITTMER",
        "first_name": "AMY",
        "middle_name": "FLANNIGAN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-05",
        "last_updated": "2015-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "ARNP3238652",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 May 5, 2015; 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.