Active NPI
Darrick Lee Studstill, RN
- General Practice Registered Nurse
- Lake Mary, FL
National Provider Identifier
1053757690
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Registered Nurse
- License
- RN9560860
- Practice address
- 255 Primera Blvd Ste 160
Lake Mary, FL 32746-2168 - Phone
- (407) 887-0245
- NPI assigned
- May 21, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Registered Nurse | 163WG0000X | RN9560860 | FL | Primary |
| Psychiatric/Mental Health Registered Nurse | 163WP0808X | 4704268271 | MI |
Addresses
Primary practice location
255 Primera Blvd Ste 160
Lake Mary, FL 32746-2168
Mailing address
255 Primera Blvd Ste 160
Lake Mary, FL 32746-2168
Phone (407) 887-0245
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN9560860 | FL | MD | General Practice Registered Nurse |
| 4704268271 | MI | MD | Psychiatric/Mental Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1645488000000",
"number": "1053757690",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "255 PRIMERA BLVD STE 160",
"city": "LAKE MARY",
"state": "FL",
"postal_code": "327462168",
"telephone_number": "407-887-0245"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "255 PRIMERA BLVD STE 160",
"city": "LAKE MARY",
"state": "FL",
"postal_code": "327462168",
"telephone_number": "407-887-0245"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STUDSTILL",
"first_name": "DARRICK",
"middle_name": "LEE",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-05-21",
"last_updated": "2022-02-22",
"certification_date": "2022-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "163WG0000X",
"taxonomy_group": "",
"desc": "Registered Nurse, General Practice",
"state": "FL",
"license": "RN9560860",
"primary": true
},
{
"code": "163WP0808X",
"taxonomy_group": "",
"desc": "Registered Nurse, Psychiatric/Mental Health",
"state": "MI",
"license": "4704268271",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lake Mary, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.