Individual provider Active NPI

Jennifer Renee Landberg, APRN

  • Family Nurse Practitioner
  • Delray Beach, FL
National Provider Identifier
1922501139
Registry record updated Oct 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9406769 Issued in FL
Practice address
475 SW 27TH Ave
Delray Beach, FL 33445-4403
Phone
(866) 910-5960
NPI assigned
Mar 14, 2018
Last updated
Oct 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP138381 TX
Family Nurse Practitioner 363LF0000X 11377393-4405 UT
Family Nurse Practitioner 363LF0000X 11377393-8900 UT
Family Nurse Practitioner 363LF0000X APRN002943 NV
Family Nurse Practitioner 363LF0000X ARNP9406769 FL Primary

Addresses

Primary practice location

475 SW 27TH Ave
Delray Beach, FL 33445-4403

Mailing address

411 12TH Ave NE
Naples, FL 34120-6317

Other practice location 1

3080 N 1700 E Ste B
Layton, UT 84040-8592
Phone (801) 825-6597

Other practice location 2

1575 Pine Ridge Rd Ste 19
Naples, FL 34109-2110
Phone (239) 593-0663

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, NV, FL3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20200124001611 UT Practitioner - Nurse Practitioner 4981950631 Reassigns benefits to 1 organization
I20200520000184 NV Practitioner - Nurse Practitioner 4981950631
I20210827001104 FL Practitioner - Nurse Practitioner 4981950631

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN002943NVMDFamily Nurse Practitioner
AP138381TXMDFamily Nurse Practitioner
11377393-8900UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Epn Urgent Care LLC Current Accepting new patients
Integrated Medical Centre of Bonita Springs Inc CurrentSince Aug 18, 2022 Accepting new patients
Urgent Care of Naples PA CurrentSince Apr 19, 2023 Accepting new patients

Locations

28315 S Tamiami Trl
Ste 101
Bonita Springs, FL 34134
Phone (239) 947-1177

6400 Davis Blvd
Ste 103
Naples, FL 34104
Phone (239) 304-0054

Interoperability endpoints

  • Direct secure messaging: jennifer.landberg.p3@direct.caremorewest.nextgenshare.com

Organizations & group practices 4

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": "1520985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665014400000",
    "number": "1922501139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 12TH AVE NE",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341206317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 SW 27TH AVE",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334454403",
            "telephone_number": "866-910-5960"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3080 N 1700 E Ste B",
            "address_purpose": "LOCATION",
            "city": "Layton",
            "state": "UT",
            "postal_code": "840408592",
            "country_code": "US",
            "telephone_number": "801-825-6597",
            "fax_number": "888-770-2983",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1575 Pine Ridge Rd Ste 19",
            "address_purpose": "LOCATION",
            "city": "Naples",
            "state": "FL",
            "postal_code": "341092110",
            "country_code": "US",
            "telephone_number": "239-593-0663",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANDBERG",
        "first_name": "JENNIFER",
        "middle_name": "RENEE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-14",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP138381",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "11377393-4405",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "11377393-8900",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "APRN002943",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9406769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delray Beach, FL

Sources for this page

Verify at the official NPI Registry.