Individual provider Active NPI

Janadra Dean Greenidge, APRN

  • Primary Care Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1881233526
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
APRN11005463 Issued in FL
Practice address
5979 Vineland Rd Ste 207
Orlando, FL 32819-7855
Phone
(407) 893-1181
Fax
(407) 440-8269
NPI assigned
Dec 28, 2019
Last updated
Jun 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

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 11005463 FL
Primary Care Nurse Practitioner 363LP2300X APRN11005463 FL Primary

Addresses

Primary practice location

5979 Vineland Rd Ste 207
Orlando, FL 32819-7855

Mailing address

5979 Vineland Rd Ste 207
Orlando, FL 32819-7855
Phone (407) 893-1181

Other names 1

  • Miss Janadra Dean Greenidge Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210921000125 FL Practitioner - Nurse Practitioner 3072910900 Reassigns benefits to 2 organizations
I20241101000601 NY Practitioner - Nurse Practitioner 3072910900

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11005463FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health System Sunbelt, Inc. Family CurrentSince Sep 16, 2021 Accepting new patients
Urgent Care Centers of Brevard County LLC Family CurrentSince Sep 16, 2021 Accepting new patients
Adventist Health System/ Sunbelt, Inc. Family CurrentSince Sep 16, 2021 Accepting new patients
Pelham Medical Practice & Aesthetic Lounge, LLC. Family Current Accepting new patients
Urgent Care Centers of Brevard County LLC Family CurrentSince Sep 16, 2021 Accepting new patients

Locations

440 W State Road 436
Altamonte Springs, FL 32714
Phone (407) 788-2000

105 S Banana River Blvd
Cocoa Beach, FL 32931
Phone (321) 783-3362

5979 Vineland Rd
Ste 207
Orlando, FL 32819
Phone (407) 345-0065

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1577491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1881233526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5979 VINELAND RD STE 207",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328197855",
            "telephone_number": "407-893-1181",
            "fax_number": "407-440-8269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5979 VINELAND RD STE 207",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328197855",
            "telephone_number": "407-893-1181",
            "fax_number": "407-440-8269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENIDGE",
        "first_name": "JANADRA",
        "middle_name": "DEAN",
        "name_prefix": "Miss",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-28",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11005463",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "APRN11005463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANADRA",
            "last_name": "GREENIDGE",
            "middle_name": "DEAN",
            "prefix": "MISS",
            "credential": "APRN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.