Active NPI
Erin Reddy
- Family Nurse Practitioner
- Clearwater, FL
National Provider Identifier
1023419744
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 064841-23
- Practice address
- 18167 US Highway 19 N Ste 650
Clearwater, FL 33764-6576 - Phone
- (727) 507-3646
- NPI assigned
- Sep 12, 2014
- Last updated
- Mar 29, 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 064841-23 | NH | Primary |
Addresses
Primary practice location
18167 US Highway 19 N Ste 650
Clearwater, FL 33764-6576
Mailing address
170 Commerce Way
Portsmouth, NH 03801-3226
Phone (603) 812-8536
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 123419744 | Medicaid | NH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250925001655 | NH | Order and Referring Only - Nurse Practitioner | 0446573901 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 064841-23 | NH | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522281600000",
"number": "1023419744",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "170 COMMERCE WAY",
"city": "PORTSMOUTH",
"state": "NH",
"postal_code": "038013226",
"telephone_number": "603-812-8536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18167 US HIGHWAY 19 N STE 650",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "337646576",
"telephone_number": "727-507-3646"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REDDY",
"first_name": "ERIN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-12",
"last_updated": "2018-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NH",
"license": "064841-23",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "123419744",
"state": "NH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clearwater, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2018; 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.