Jacquelyn Marie Walsh, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

ARNP9492462 Issued in FL

Practice address

625 6TH Ave S Ste 310
St Petersburg, FL 33701-4664

Phone

(727) 767-2243

Fax

(727) 767-4299

NPI assigned

Dec 23, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network

Interoperability endpoints

• Direct secure messaging: jwalsh811981@direct.hopkinsmedicine.org

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.

• Mori Bean and Brooks Inc

  • Diagnostic Radiology Physician
  • Tampa, FL
  • NPI 1093782070
  Medicare reassignment NPD
• Pediatric Physician Services, Inc.

  • Pediatrics Physician
  • St Petersburg, FL
  • NPI 1770532798
  Medicare reassignment NPD (past)
• David E Kim MD PC

  • Internal Medicine Physician
  • Cartersville, GA
  • NPI 1194919381
  NPD (past)
• Northside Radiology Associates LLC

  • Diagnostic Radiology Physician
  • Atlanta, GA
  • NPI 1013960657
  NPD (past)
• The Healthcaring Clinic of Georgia, LLC

  • Family Nurse Practitioner
  • Cartersville, GA
  • NPI 1669539508
  NPD (past)

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

{
    "created_epoch": "1324598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653609600000",
    "number": "1891064655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 W TRILBY AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336114430",
            "telephone_number": "813-777-9522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 6TH AVE S STE 310",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014664",
            "telephone_number": "727-767-2243",
            "fax_number": "727-767-4299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2700 University Square Dr",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336125513",
            "country_code": "US",
            "telephone_number": "813-253-2721",
            "fax_number": "813-977-3720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALSH",
        "first_name": "JACQUELYN",
        "middle_name": "MARIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-23",
        "last_updated": "2022-05-27",
        "certification_date": "2022-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN214988",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9492462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phoebe Waller, M.S., CCC-SLP
• Nancy E Wallick, LCSW
• Maria Wallis-Crespo, M.D.
• Wachira Wallis
• Audra Mary Walsh, PH.D.
• John W. Walsh, M.D.
• Walter G Griffith Jr MD PA
• Jolan E Walter, M.D.
• Karl Henry Walter, RPH
• Kimberly Anne Walter, PHARMD

• Family Nurse Practitioner in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.