Active NPI
Tami Leigh Newbern, ARNP
- Pediatric Nurse Practitioner
- Saint Johns, FL
National Provider Identifier
1871888073
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- ARNP 9237911
- Practice address
- 1631 Race Track Rd Ste 101
Saint Johns, FL 32259-3233 - Phone
- (904) 230-7977
- NPI assigned
- Jun 15, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | ARNP 9237911 | FL | Primary |
Addresses
Primary practice location
1631 Race Track Rd Ste 101
Saint Johns, FL 32259-3233
Mailing address
1631 Race Track Rd Ste 101
Saint Johns, FL 32259-3233
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 |
|---|---|---|---|
| ARNP 9237911 | FL | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric Associates of Julington Creek | Past | Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/JCFAAA
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Pediatrics Physician
- Jacksonville, FL
- NPI 1235276254
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343174400000",
"number": "1871888073",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1631 RACE TRACK RD STE 101",
"city": "SAINT JOHNS",
"state": "FL",
"postal_code": "322593233"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1631 RACE TRACK RD STE 101",
"city": "SAINT JOHNS",
"state": "FL",
"postal_code": "322593233",
"telephone_number": "904-230-7977"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEWBERN",
"first_name": "TAMI",
"middle_name": "LEIGH",
"name_prefix": "Mrs.",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-15",
"last_updated": "2012-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "FL",
"license": "ARNP 9237911",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Johns, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.