Individual provider Active NPI

Alicia Pool Hanlon, ARNP

  • Family Nurse Practitioner
  • Groveland, FL
National Provider Identifier
1013462308
Registry record updated Apr 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9308692 Issued in FL
Practice address
612 S Main Ave
Groveland, FL 34736-2732
Phone
(352) 409-4782
NPI assigned
Aug 17, 2016
Last updated
Apr 30, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9308692 FL Primary

Addresses

Primary practice location

612 S Main Ave
Groveland, FL 34736-2732

Mailing address

612 S Main Ave
Groveland, FL 34736-2732
Phone (352) 409-4782

Other names 1

  • Martha Alicia Pool Former name

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
I20180724002029 FL Practitioner - Nurse Practitioner 3375890270 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9308692FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pulmonary Group of Central Florida, LLC CurrentSince Jun 1, 2018 Accepting new patients
Lake Pulmonary & Sleep Disorders Clinic P.a. CurrentSince Sep 3, 2018 Accepting new patients
Hilbert Zeballos PA PastSince May 19, 2013 Accepting new patients

Locations

1038 W North Blvd
Ste 102
Leesburg, FL 34748
Phone (352) 315-1627

501 Medical Plaza Dr
Ste 102
Leesburg, FL 34748
Phone (352) 728-0709

Interoperability endpoints

  • Direct secure messaging: ahanlon563873@direct.shands.ufl.edu
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 3

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": "1471392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525046400000",
    "number": "1013462308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 S MAIN AVE",
            "city": "GROVELAND",
            "state": "FL",
            "postal_code": "347362732",
            "telephone_number": "352-409-4782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 S MAIN AVE",
            "city": "GROVELAND",
            "state": "FL",
            "postal_code": "347362732",
            "telephone_number": "352-409-4782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANLON",
        "first_name": "ALICIA",
        "middle_name": "POOL",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-17",
        "last_updated": "2018-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9308692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARTHA",
            "last_name": "POOL",
            "middle_name": "ALICIA",
            "credential": "ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Groveland, FL

Sources for this page

Verify at the official NPI Registry.