Individual provider Active NPI

Jacqueline T. Harang, APRN

  • Family Nurse Practitioner
  • St Petersburg, FL
National Provider Identifier
1831690650
Registry record updated Nov 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN9330636 Issued in FL
Practice address
1839 Central Ave
St Petersburg, FL 33713-8900
Phone
(813) 210-3544
NPI assigned
Feb 27, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP9330636 FL
Family Nurse Practitioner 363LF0000X APRN9330636 FL Primary

Addresses

Primary practice location

1839 Central Ave
St Petersburg, FL 33713-8900

Mailing address

1839 Central Ave
St Petersburg, FL 33713-8900
Phone (727) 820-1040

Other practice location 1

12148 Cortez Blvd
Brooksville, FL 34613
Phone (352) 597-7184

Other identifiers 1

IdentifierTypeStateIssuer
102405800MedicaidFL

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
I20180508002477 FL Practitioner - Nurse Practitioner 8527322064 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN9330636FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Health Care of Pinellas Inc. CurrentSince Mar 15, 2019 Accepting new patients
Professional Health Care of Pinellas LLC CurrentSince Mar 15, 2019 Accepting new patients

Locations

1839 Central Ave
St Petersburg, FL 33713
Phone (727) 322-1054

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EIJHAA

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": "1519689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573776000000",
    "number": "1831690650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1839 CENTRAL AVE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337138900",
            "telephone_number": "727-820-1040",
            "fax_number": "727-821-7213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1839 CENTRAL AVE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337138900",
            "telephone_number": "813-210-3544"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12148 Cortez Blvd",
            "address_purpose": "LOCATION",
            "city": "Brooksville",
            "state": "FL",
            "postal_code": "34613",
            "country_code": "US",
            "telephone_number": "352-597-7184",
            "fax_number": "352-597-7186",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARANG",
        "first_name": "JACQUELINE",
        "middle_name": "T.",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-27",
        "last_updated": "2019-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9330636",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9330636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102405800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.