Individual provider Active NPI

Kimberly Langen

  • Nurse Practitioner
  • Plantation, FL
National Provider Identifier
1770022683
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN9278234 Issued in FL
Practice address
9611 W Broward Blvd
Plantation, FL 33324-2334
Phone
(954) 924-7000
NPI assigned
Feb 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 9278234 FL
Pediatric Nurse Practitioner 363LP0200X APRN9278234 FL
Nurse Practitioner 363L00000X APRN9278234 FL Primary

Addresses

Primary practice location

9611 W Broward Blvd
Plantation, FL 33324-2334

Mailing address

4792 Coquina Key Dr SE
Saint Petersburg, FL 33705-4813

Other practice location 1

4972 Town Center Pkwy Unit 301
Jacksonville, FL 32246-8596
Phone (904) 642-6100

Other practice location 2

7500 Park Blvd N
Pinellas Park, FL 33781-3701
Phone (727) 544-5437

Other practice location 3

11260 Sullivan St
Riverview, FL 33578-2140
Phone (813) 689-7571

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
9278234FLMDFamily Medicine Physician
APRN9278234FLMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mariano D Cibran, MD Corp Dba St Petersburg Pediatrics PastSince Jun 22, 2021 Accepting new patients
Mariano D Cibran, MD Corp Dba St Petersburg Pediatrics Pediatrics Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1486944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1770022683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4792 COQUINA KEY DR SE",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337054813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9611 W BROWARD BLVD",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333242334",
            "telephone_number": "954-924-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4972 Town Center Pkwy Unit 301",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322468596",
            "country_code": "US",
            "telephone_number": "904-642-6100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7500 Park Blvd N",
            "address_purpose": "LOCATION",
            "city": "Pinellas Park",
            "state": "FL",
            "postal_code": "337813701",
            "country_code": "US",
            "telephone_number": "727-544-5437",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11260 Sullivan St",
            "address_purpose": "LOCATION",
            "city": "Riverview",
            "state": "FL",
            "postal_code": "335782140",
            "country_code": "US",
            "telephone_number": "813-689-7571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANGEN",
        "first_name": "KIMBERLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-13",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "9278234",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "APRN9278234",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN9278234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2023; 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.