Individual provider Active NPI

Gregg Steven Halverson, APRN

  • Family Nurse Practitioner
  • Orange Park, FL
National Provider Identifier
1033776539
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11001570 Issued in FL
Practice address
1542 Kingsley Ave Ste 136
Orange Park, FL 32073-4547
Phone
(904) 458-7780
NPI assigned
May 21, 2019
Last updated
Aug 30, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2021033954 FL
Family Nurse Practitioner 363LF0000X 11001570 FL Primary

Addresses

Primary practice location

1542 Kingsley Ave Ste 136
Orange Park, FL 32073-4547

Mailing address

1542 Kingsley Ave Ste 136
Orange Park, FL 32073-4547
Phone (904) 458-7780

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
I20210625000111 FL Practitioner - Nurse Practitioner 6608277892 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2055 Reyko Rd
Suite 100
Jacksonville, FL 32207-2822
Phone (904) 648-8200

Merit-based Incentive Payment System (MIPS)

Final score
87.43 of 100Reported as group
Quality
74.02
Promoting interoperability
100
Improvement activities
40
Cost
77.26

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11001570FLMDFamily Nurse Practitioner
2021033954FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dna Comprehensive Therapy Services, LLC CurrentSince Jun 30, 2023 Accepting new patients
Thriveworks Clinical - Florida Inc CurrentSince Aug 24, 2021 Accepting new patients
Bonita Springs Retirement Village, Inc. CurrentSince Jun 30, 2023 Accepting new patients
Gulf to Bay Infectious Disease Consultants PLLC PastSince Mar 14, 2022 Accepting new patients

Locations

4310 Metro Pkwy
Ste 205
Fort Myers, FL 33916

4243 Sunbeam Rd
Ste 6
Jacksonville, FL 32257
Phone (904) 299-0184

2055 Reyko Rd
Ste 100
Jacksonville, FL 32207
Phone (904) 648-8200

1542 Kingsley Ave
Ste 136
Orange Park, FL 32073
Phone (904) 214-3222

3191 Harbor Blvd
Ste A
Pt Charlotte, FL 33952
Phone (941) 766-9555

4115 W Spruce St
Ste 205
Tampa, FL 33607
Phone (813) 413-4663

5825 Argerian Dr
Ste 101
Wesley Chapel, FL 33545
Phone (813) 687-4870

1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263

Interoperability endpoints

  • Direct secure messaging: gregg.halverson.1@13142.direct.athenahealth.com

Organizations & group practices 4

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": "1558396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1033776539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1542 KINGSLEY AVE STE 136",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734547",
            "telephone_number": "904-458-7780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1542 KINGSLEY AVE STE 136",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734547",
            "telephone_number": "904-458-7780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALVERSON",
        "first_name": "GREGG",
        "middle_name": "STEVEN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-21",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "2021033954",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11001570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

Verify at the official NPI Registry.