Active NPI
Debra A Hendren, FNP
- Family Nurse Practitioner
- St Petersburg, FL
National Provider Identifier
1912914078
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- ARNP9427949
- Practice address
- 1344 22ND St S
Saint Petersburg, FL 33712-2744 - Phone
- (901) 481-4642
- Fax
- (727) 824-8150
- NPI assigned
- Aug 2, 2006
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | ARNP9427949 | FL | Primary |
Addresses
Primary practice location
1344 22ND St S
Saint Petersburg, FL 33712-2744
Mailing address
PO Box 10549
Saint Petersburg, FL 33733-0549
Phone (727) 824-8181
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 123327100 | Medicaid | WY | |
| BLUE CROSS OF WY | Other | WY | WY BLUE CROSS BLUE SHIELD |
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5547 | TN | MD | Internal Medicine Physician |
| ARNP9427949 | FL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Urgent Care of Wyoming Inc. | Past | Accepting new patients |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1469664000000",
"number": "1912914078",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10549",
"city": "SAINT PETERSBURG",
"state": "FL",
"postal_code": "337330549",
"telephone_number": "727-824-8181"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1344 22ND ST S",
"city": "SAINT PETERSBURG",
"state": "FL",
"postal_code": "337122744",
"telephone_number": "901-481-4642",
"fax_number": "727-824-8150"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDREN",
"first_name": "DEBRA",
"middle_name": "A",
"name_prefix": "Mrs.",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-02",
"last_updated": "2016-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "FL",
"license": "ARNP9427949",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "123327100",
"state": "WY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WY BLUE CROSS BLUE SHIELD",
"identifier": "BLUE CROSS OF WY",
"state": "WY"
}
],
"endpoints": [],
"other_names": []
}Other providers in St Petersburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.