Individual provider Active NPI

Joanne Dematteo, CRNFA

  • Registered Nurse First Assistant
  • Tampa, FL
National Provider Identifier
1902195951
Registry record updated Jun 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered Nurse First AssistantTaxonomy code 163WR0006X
License
26NR14998400 Issued in NJ
Practice address
12880 Commodity PL
Tampa, FL 33626-3101
Phone
(813) 343-5500
Fax
(866) 462-7445
NPI assigned
Mar 30, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse First Assistant 163WR0006X 26NR14998400 NJ Primary
Registered Nurse First Assistant 163WR0006X RN553033 PA

Addresses

Primary practice location

12880 Commodity PL
Tampa, FL 33626-3101

Mailing address

12880 Commodity PL
Tampa, FL 33626-3101
Phone (813) 343-5500

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
26NR14998400NJMDRegistered Nurse First Assistant
RN553033PAMDRegistered Nurse First Assistant

NPI Registry JSON

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

{
    "created_epoch": "1301443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434412800000",
    "number": "1902195951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12880 COMMODITY PL",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336263101",
            "telephone_number": "813-343-5500",
            "fax_number": "866-462-7445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12880 COMMODITY PL",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336263101",
            "telephone_number": "813-343-5500",
            "fax_number": "866-462-7445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMATTEO",
        "first_name": "JOANNE",
        "credential": "CRNFA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-30",
        "last_updated": "2015-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "NJ",
            "license": "26NR14998400",
            "primary": true
        },
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "PA",
            "license": "RN553033",
            "primary": false
        }
    ],
    "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 16, 2015; 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.