Individual provider Active NPI

Emma Grace Prosser, APRN

  • Pediatric Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1053973248
Registry record updated Apr 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
APRN11002134 Issued in FL
Practice address
1222 S Orange Ave 2ND FL
Orlando, FL 32806-1106
Phone
(321) 843-3220
Fax
(321) 843-3210
NPI assigned
Jul 8, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11002134 FL
Pediatric Nurse Practitioner 363LP0200X APRN11002134 FL Primary

Addresses

Primary practice location

1222 S Orange Ave 2ND FL
Orlando, FL 32806-1106

Mailing address

1222 S Orange Ave 2ND FL
Orlando, FL 32806-1106
Phone (321) 841-1700

Other identifiers 1

IdentifierTypeStateIssuer
103757400MedicaidFL

Other names 1

  • Ms. Emma Grace Phillips Former name

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
I20190826001807 FL Practitioner - Nurse Practitioner 1759619992 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

83 Columbia St
Orlando, FL 32806-1106
Phone (321) 841-6350

Merit-based Incentive Payment System (MIPS)

Final score
79.91 of 100Reported as group
Quality
61.18
Promoting interoperability
100
Improvement activities
40
Cost
71.86

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11002134FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc CurrentSince Sep 1, 2019 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Sep 1, 2019 Accepting new patients
Orlando Health, Inc. Current Accepting new patients

Locations

83 Columbia St
Orlando, FL 32806
Phone (321) 843-3220

1222 S Orange Ave
Fl 2
Orlando, FL 32806
Phone (321) 843-3220

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

Interoperability endpoints

  • Direct secure messaging: eprosser28188@orlandohealth.medalliesdirect.net

Organizations & group practices 3

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": "1562544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618790400000",
    "number": "1053973248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1222 S ORANGE AVE 2ND FL",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061106",
            "telephone_number": "321-841-1700",
            "fax_number": "321-841-1906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 S ORANGE AVE 2ND FL",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061106",
            "telephone_number": "321-843-3220",
            "fax_number": "321-843-3210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROSSER",
        "first_name": "EMMA",
        "middle_name": "GRACE",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-08",
        "last_updated": "2021-04-19",
        "certification_date": "2021-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11002134",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "APRN11002134",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103757400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMMA",
            "last_name": "PHILLIPS",
            "middle_name": "GRACE",
            "prefix": "MS.",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.