Individual provider Active NPI

Marie-Maurice Celsis Anglin, ARNP

  • Nurse Practitioner
  • Gainesville, FL
National Provider Identifier
1053622597
Registry record updated Dec 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP 993452 Issued in FL
Practice address
224 SE 24TH St
Gainesville, FL 32641-7516
Phone
(352) 334-7906
Fax
(352) 334-8897
NPI assigned
Jun 30, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP 993452 FL Primary

Addresses

Primary practice location

224 SE 24TH St
Gainesville, FL 32641-7516

Mailing address

224 SE 24TH St
Gainesville, FL 32641-7516
Phone (352) 334-7906

Other identifiers 1

IdentifierTypeStateIssuer
002250600MedicaidFL

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
I20130114000332 FL Practitioner - Nurse Practitioner 9133372568 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP 993452FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Department of Health CurrentSince Jun 16, 2022 Accepting new patients
Florida Department of Health CurrentSince Jun 16, 2022 Accepting new patients

Locations

224 SE 24th St
Gainesville, FL 32641
Phone (352) 334-7900

1728 NW 9th Ave
Okeechobee, FL 34972
Phone (863) 462-5779

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1277856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355702400000",
    "number": "1053622597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 SE 24TH ST",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326417516",
            "telephone_number": "352-334-7906",
            "fax_number": "352-334-8897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 SE 24TH ST",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326417516",
            "telephone_number": "352-334-7906",
            "fax_number": "352-334-8897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGLIN",
        "first_name": "MARIE-MAURICE",
        "middle_name": "CELSIS",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-30",
        "last_updated": "2012-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP 993452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002250600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.