Individual provider Active NPI

Heather Marie Ponall, APRN

  • Family Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1851540728
Registry record updated Jun 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9200004 Issued in FL
Practice address
3910 Northdale Blvd Ste 206
Tampa, FL 33624
Phone
(813) 264-7922
NPI assigned
Sep 16, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2019

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 9200004 FL Primary

Addresses

Primary practice location

3910 Northdale Blvd Ste 206
Tampa, FL 33624

Mailing address

5139 Karlsburg PL
Palm Harbor, FL 34685-3619
Phone (727) 644-1388

Other practice location 1

5115 N Armenia Ave
Tampa, FL 33603-1405
Phone (813) 870-1292 ext. 221

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
9200004FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sterk Family Medicine LLC PastSince Aug 1, 2021 Accepting new patients
Dr Lynn Family Practice PA 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": "1221523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561507200000",
    "number": "1851540728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5139 KARLSBURG PL",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346853619",
            "telephone_number": "727-644-1388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3910 NORTHDALE BLVD STE 206",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33624",
            "telephone_number": "813-264-7922"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5115 N Armenia Ave",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336031405",
            "country_code": "US",
            "telephone_number": "813-870-1292 x221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PONALL",
        "first_name": "HEATHER",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-16",
        "last_updated": "2019-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9200004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2019; 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.