Active NPI
Johanna Ivich, NNP-BC
- Neonatal Nurse Practitioner
- Tampa, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal Nurse Practitioner
- License
- APRN9363820
- Practice address
- 3100 E Fletcher Ave
Tampa, FL 33613-4613 - Phone
- (813) 467-4770
- Fax
- (813) 467-4243
- NPI assigned
- May 7, 2013
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neonatal-Perinatal Medicine Physician | 2080N0001X | ARNP9363820 | FL | |
| Nurse Practitioner | 363L00000X | ARNP9363820 | FL | |
| Critical Care Neonatal Nurse Practitioner | 363LN0005X | ARNP9363820 | FL | |
| Neonatal Nurse Practitioner | 363LN0000X | APRN9363820 | FL | Primary |
Addresses
Primary practice location
3100 E Fletcher Ave
Tampa, FL 33613-4613
Mailing address
PO Box 917770
Orlando, FL 32891-0001
Phone (813) 974-2201
Other practice location 1
601 5th St S
Dept #6590070301
St Petersburg, FL 33701-4804
Phone (727) 767-3051
Other practice location 2
13535 Nemours Pkwy
Orlando, FL 32827-7402
Phone (407) 567-4000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100145500 | Medicaid | FL | |
| AL8JF | Other | FL | BLUE CROSS BLUE SHIELD |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jivich144730@direct.tgh.org |
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ARNP9363820 | FL | MD | Critical Care Neonatal Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Hospital Medical Group Inc | Current | Accepting new patients | |
| Florida Hospital Medical Group Inc | Nurse Practitioner | Current | Accepting new patients |
Locations
2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700
3100 E Fletcher Ave
Tampa, FL 33613
Phone (813) 615-7200
Interoperability endpoints
- jivich4164120@adventhealth.direct-ci.com
- jivich961824@direct.hopkinsmedicine.org
Organizations & group practices 2
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.
-
dba AdventHealth Medical Group
- Family Medicine Physician
- Orlando, FL
- NPI 1225034234
Nurse Practitioner
-
dba Rothman Orthopaedics AdventHealth Medical Group at Minneola
- Prosthetic/Orthotic Supplier
- Minneola, FL
- NPI 1285591545
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1367884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739923200000",
"number": "1952746703",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 917770",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328910001",
"telephone_number": "813-974-2201",
"fax_number": "813-974-2812"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 E FLETCHER AVE",
"city": "TAMPA",
"state": "FL",
"postal_code": "336134613",
"telephone_number": "813-467-4770",
"fax_number": "813-467-4243"
}
],
"practiceLocations": [
{
"address_1": "601 5th St S",
"address_2": "Dept #6590070301",
"address_purpose": "LOCATION",
"city": "St Petersburg",
"state": "FL",
"postal_code": "337014804",
"country_code": "US",
"telephone_number": "727-767-3051",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "13535 Nemours Pkwy",
"address_purpose": "LOCATION",
"city": "Orlando",
"state": "FL",
"postal_code": "328277402",
"country_code": "US",
"telephone_number": "407-567-4000",
"fax_number": "407-567-5924",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "IVICH",
"first_name": "JOHANNA",
"name_prefix": "Mrs.",
"credential": "NNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-05-07",
"last_updated": "2025-02-19",
"certification_date": "2025-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "FL",
"license": "ARNP9363820",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "FL",
"license": "ARNP9363820",
"primary": false
},
{
"code": "363LN0005X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Neonatal, Critical Care",
"state": "FL",
"license": "ARNP9363820",
"primary": false
},
{
"code": "363LN0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Neonatal",
"state": "FL",
"license": "APRN9363820",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100145500",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "AL8JF",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jivich144730@direct.tgh.org",
"affiliation": "N",
"address_1": "601 5th St S",
"address_2": "Dept #6590070301",
"city": "St Petersburg",
"state": "FL",
"country_code": "US",
"postal_code": "337014804",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Feb 19, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.