Active NPI
Darlene M Vontobel, A.R.N.P.
- Pediatric Nurse Practitioner
- Jacksonville, FL
National Provider Identifier
1932115383
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- ARNP1585122
- Practice address
- 1906 Southside Blvd
Jacksonville, FL 32216-1930 - Phone
- (904) 724-3083
- Fax
- (904) 727-9103
- NPI assigned
- Jul 31, 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 |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | ARNP1585122 | FL | Primary |
Addresses
Primary practice location
1906 Southside Blvd
Jacksonville, FL 32216-1930
Mailing address
PO Box 850001
Orlando, FL 32885-0192
Phone (904) 282-6331
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 304035600 | Medicaid | FL |
Other names 1
- Miss Darlene Marie Krzyzaniak
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ARNP1585122 | FL | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physicians Group Services PA | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- darlene.vontobel.1@14736.direct.athenahealth.com
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": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439856000000",
"number": "1932115383",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 850001",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328850192",
"telephone_number": "904-282-6331",
"fax_number": "904-282-4117"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1906 SOUTHSIDE BLVD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322161930",
"telephone_number": "904-724-3083",
"fax_number": "904-727-9103"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VONTOBEL",
"first_name": "DARLENE",
"middle_name": "M",
"name_prefix": "Mrs.",
"credential": "A.R.N.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-31",
"last_updated": "2015-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "FL",
"license": "ARNP1585122",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "304035600",
"state": "FL"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "DARLENE",
"last_name": "KRZYZANIAK",
"middle_name": "MARIE",
"prefix": "MISS",
"credential": "A.R.N.P.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.