Individual provider Active NPI

Vivian W. Endaya

  • Gerontology Nurse Practitioner
  • New Port Richey, FL
National Provider Identifier
1053707992
Registry record updated Apr 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
ARNP 2839572 Issued in FL
Practice address
9530 Riverchase Dr
New Port Richey, FL 34655-5720
Phone
(301) 356-8147
NPI assigned
Apr 7, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X ARNP 2839572 FL Primary

Addresses

Primary practice location

9530 Riverchase Dr
New Port Richey, FL 34655-5720

Mailing address

9530 Riverchase Dr
New Port Richey, FL 34655-5720
Phone (301) 356-8147

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ARNP 2839572FLMDGerontology Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1428364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428364800000",
    "number": "1053707992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9530 RIVERCHASE DR",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346555720",
            "telephone_number": "301-356-8147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9530 RIVERCHASE DR",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346555720",
            "telephone_number": "301-356-8147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENDAYA",
        "first_name": "VIVIAN",
        "middle_name": "W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-07",
        "last_updated": "2015-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "ARNP 2839572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Port Richey, FL

Sources for this page

Verify at the official NPI Registry.