Active NPI
Nicole Marie Klopotek, CST-CERT SURG TECH
- Non-emergency Medical Transport (VAN)
- Jacksonville, FL
National Provider Identifier
1790493344
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Non-emergency Medical Transport (VAN)
- Practice address
- 8681 A C Skinner Pkwy Apt 634
Jacksonville, FL 32256-0846 - Phone
- (904) 522-4144
- NPI assigned
- Nov 14, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Technologist | 246ZS0410X | 148606 | FL | |
| Non-emergency Medical Transport (VAN) | 343900000X | Primary |
Addresses
Primary practice location
8681 A C Skinner Pkwy Apt 634
Jacksonville, FL 32256-0846
Mailing address
8681 A C Skinner Pkwy Apt 634
Jacksonville, FL 32256-0846
Phone (904) 522-4144
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | email@jnr-transport.com | Direct |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 148606 | FL | MD | Surgical Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1668384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668384000000",
"number": "1790493344",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8681 A C SKINNER PKWY APT 634",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322560846",
"telephone_number": "904-522-4144"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8681 A C SKINNER PKWY APT 634",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322560846",
"telephone_number": "904-522-4144"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLOPOTEK",
"first_name": "NICOLE",
"middle_name": "MARIE",
"name_prefix": "Miss",
"credential": "CST-CERT SURG TECH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-11-14",
"last_updated": "2022-11-14",
"certification_date": "2022-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "246ZS0410X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Technologist",
"state": "FL",
"license": "148606",
"primary": false
},
{
"code": "343900000X",
"taxonomy_group": "",
"desc": "Non-emergency Medical Transport (VAN)",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "email@jnr-transport.com",
"affiliation": "N",
"endpointDescription": "biz email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "email",
"address_1": "8681 A C Skinner Pkwy Apt 634",
"city": "Jacksonville",
"state": "FL",
"country_code": "US",
"postal_code": "322560846",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.