Active NPI
Erin Omalley
- Psychiatric/Mental Health Nurse Practitioner
- Gainesville, FL
National Provider Identifier
1033627997
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 2017032723
- Practice address
- 1601 SW Archer Rd
Gainesville, FL 32608-1135 - Phone
- (352) 376-1611
- NPI assigned
- Jan 12, 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 |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 2017032723 | MO | Primary |
Addresses
Primary practice location
1601 SW Archer Rd
Gainesville, FL 32608-1135
Mailing address
3630 Old Hopper Rd
Cape Girardeau, MO 63701-3423
Phone (618) 830-3914
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
- 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 |
|---|---|---|---|---|
| I20210726002425 | IA | Order and Referring Only - Nurse Practitioner | 2668875857 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2017032723 | MO | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1515715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626652800000",
"number": "1033627997",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3630 OLD HOPPER RD",
"city": "CAPE GIRARDEAU",
"state": "MO",
"postal_code": "637013423",
"telephone_number": "618-830-3914"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1601 SW ARCHER RD",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326081135",
"telephone_number": "352-376-1611"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OMALLEY",
"first_name": "ERIN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-01-12",
"last_updated": "2021-07-19",
"certification_date": "2021-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "MO",
"license": "2017032723",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gainesville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2021; 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.