Active NPI
Jennifer Lorraine Spicer, APRN
- Nurse Practitioner
- Melbourne, FL
National Provider Identifier
1932616364
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- APRN3385012
- Practice address
- 1223 Gateway Dr
Melbourne, FL 32901-2607 - Phone
- (321) 434-9561
- Fax
- (321) 434-9231
- NPI assigned
- Jan 8, 2018
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | APRN3385012 | FL | Primary |
Addresses
Primary practice location
1223 Gateway Dr
Melbourne, FL 32901-2607
Mailing address
3300 S Fiske Blvd
Rockledge, FL 32955-4306
Phone (321) 434-9561
Other practice location 1
8725 N Wickham Rd
Melbourne, FL 32940-2239
Phone (321) 434-9561
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 105141800 | Medicaid | FL | |
| QG417 | Other | FL | HFMG MA |
Other names 1
- Jennifer Lorraine Imperato
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1223 Gateway Dr
Melbourne, FL 32901-2607
Phone (321) 725-4500
Hospital & facility affiliations
- Holmes Regional Medical Center
- Viera Hospital
- Palm Bay Hospital
- Cape Canaveral Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN3385012 | FL | MD | Nurse Practitioner |
Interoperability endpoints
- jspicer222944@adventhealth.direct-ci.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.
-
- General Practice Physician
- Melbourne, FL
- NPI 1750626495
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Cocoa Beach, FL
- NPI 1184691610
-
- General Acute Care Hospital
- Palm Bay, FL
- NPI 1386940823
-
- General Acute Care Hospital
- Melbourne, FL
- NPI 1295702728
-
- General Acute Care Hospital
- Melbourne, FL
- NPI 1730494816
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1515369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730678400000",
"number": "1932616364",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3300 S FISKE BLVD",
"city": "ROCKLEDGE",
"state": "FL",
"postal_code": "329554306",
"telephone_number": "321-434-9561"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1223 GATEWAY DR",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329012607",
"telephone_number": "321-434-9561",
"fax_number": "321-434-9231"
}
],
"practiceLocations": [
{
"address_1": "8725 N Wickham Rd",
"address_purpose": "LOCATION",
"city": "Melbourne",
"state": "FL",
"postal_code": "329402239",
"country_code": "US",
"telephone_number": "321-434-9561",
"fax_number": "321-434-9231",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SPICER",
"first_name": "JENNIFER",
"middle_name": "LORRAINE",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-01-08",
"last_updated": "2024-11-04",
"certification_date": "2024-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "FL",
"license": "APRN3385012",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "105141800",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HFMG MA",
"identifier": "QG417",
"state": "FL"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JENNIFER",
"last_name": "IMPERATO",
"middle_name": "LORRAINE",
"credential": "APRN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Melbourne, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.