Individual provider Active NPI

Jura Tillman Kilpatrick, A

  • Adult Health Nurse Practitioner
  • Oldsmar, FL
National Provider Identifier
1790838290
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
ARNP803702 Issued in FL
Practice address
601 Brooker Creek Blvd
Oldsmar, FL 34677-2962
Phone
(813) 818-3200
NPI assigned
Jan 19, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X ARNP803702 FL Primary

Addresses

Primary practice location

601 Brooker Creek Blvd
Oldsmar, FL 34677-2962

Mailing address

11514 Walker Rd
Thonotosassa, FL 33592-3618
Phone (813) 986-1180

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151020003052 FL Practitioner - Nurse Practitioner 5496839482

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790838290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11514 WALKER RD",
            "city": "THONOTOSASSA",
            "state": "FL",
            "postal_code": "335923618",
            "telephone_number": "813-986-1180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 BROOKER CREEK BLVD",
            "city": "OLDSMAR",
            "state": "FL",
            "postal_code": "346772962",
            "telephone_number": "813-818-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILPATRICK",
        "first_name": "JURA",
        "middle_name": "TILLMAN",
        "name_prefix": "Mrs.",
        "credential": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP803702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oldsmar, FL

Sources for this page

Verify at the official NPI Registry.