Individual provider Active NPI

Darrick Lee Studstill, RN

  • General Practice Registered Nurse
  • Lake Mary, FL
National Provider Identifier
1053757690
Registry record updated Feb 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
RN9560860 Issued in FL
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

Updated by the provider on Feb 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
RN9560860FLMDGeneral Practice Registered Nurse
4704268271MIMDPsychiatric/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.

Verify at the official NPI Registry.