Individual provider Active NPI

Jessica Ann Dacosta, FNP

  • Family Nurse Practitioner
  • Kissimmee, FL
National Provider Identifier
1831613660
Registry record updated Jan 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN9238355 Issued in FL
Practice address
700 W Oak St
Kissimmee, FL 34741-4924
Phone
(407) 846-2266
NPI assigned
Aug 2, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN9238355 FL Primary

Addresses

Primary practice location

700 W Oak St
Kissimmee, FL 34741-4924

Mailing address

700 W Oak St
Kissimmee, FL 34741-4924
Phone (407) 846-2266

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN9238355FLMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1501632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516752000000",
    "number": "1831613660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 W OAK ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414924",
            "telephone_number": "407-846-2266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W OAK ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414924",
            "telephone_number": "407-846-2266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DACOSTA",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-02",
        "last_updated": "2018-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "RN9238355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2018; 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.