Individual provider Active NPI

Hansie Camille Jean, DNP, APRN, AGNP-BC

  • Primary Care Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1063015485
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
APRN11024097 Issued in FL
Practice address
5900 Lake Ellenor Dr
Orlando, FL 32809-4618
Phone
(321) 557-7347
NPI assigned
Nov 18, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 9247498 FL
Gerontology Nurse Practitioner 363LG0600X APRN11024097 FL
Primary Care Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP2300X APRN11024097 FL Primary

Addresses

Primary practice location

5900 Lake Ellenor Dr
Orlando, FL 32809-4618

Mailing address

5900 Lake Ellenor Dr Ste 700C
Orlando, FL 32809-4618
Phone (407) 352-2542

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
I20230908001963 FL Practitioner - Nurse Practitioner 3173987153 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Physician Group IncGroup PAC ID 2365679057, 953 clinicians

Practice addresses (Care Compare)

2700 Healing Way
Wesley Chapel, FL 33543-5453

Hospital & facility affiliations

  • Adventhealth Dade City Hospital, Dade City, FL, CCN 100211
  • Adventhealth Zephyrhills Hospital, Zephyrhills, FL, CCN 100046

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9247498FLMDCritical Care Medicine Registered Nurse
APRN11024097FLMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kopa Health Services LLC CurrentSince Aug 27, 2023 Accepting new patients
Florida Hospital Physician Group Inc Single Specialty CurrentSince Jun 15, 2024 Accepting new patients
Adventist Health System-Sunbelt Inc Single Specialty CurrentSince Jun 15, 2024 Accepting new patients
Adventist Health System-Sunbelt Inc Single Specialty CurrentSince Jun 15, 2024 Accepting new patients

Locations

1210 US Highway 27 N
Lake Placid, FL 33852
Phone (863) 465-3777

5900 Lk Ellenor Dr
Ste 700C
Orlando, FL 32809
Phone (561) 305-8836

13901 Bruce B Downs Blvd
Tampa, FL 33613
Phone (813) 615-7260

522 Carlton St
Wauchula, FL 33873
Phone (863) 773-0975

2700 Healing Way
Ste 310
Wesley Chapel, FL 33543
Phone (813) 779-1209

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1605657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1063015485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 LAKE ELLENOR DR STE 700C",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328094618",
            "telephone_number": "407-352-2542",
            "fax_number": "407-352-2547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 LAKE ELLENOR DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328094618",
            "telephone_number": "321-557-7347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEAN",
        "first_name": "HANSIE",
        "middle_name": "CAMILLE",
        "name_prefix": "Dr.",
        "credential": "DNP, APRN, AGNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-18",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "FL",
            "license": "9247498",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "APRN11024097",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "APRN11024097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.