Individual provider Active NPI

Johanna Ivich, NNP-BC

  • Neonatal Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1952746703
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
APRN9363820 Issued in FL
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

Updated by the provider on Feb 19, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
100145500MedicaidFL
AL8JFOtherFLBLUE CROSS BLUE SHIELD

Electronic endpoints 1

TypeEndpointUseAffiliation
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250327001109 FL Practitioner - Nurse Practitioner 9830612126 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9363820FLMDCritical Care Neonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Dec 21, 2024 Accepting new patients
Florida Hospital Medical Group Inc Nurse Practitioner CurrentSince Dec 21, 2024 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

  • Direct secure messaging: jivich4164120@adventhealth.direct-ci.com
  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.