Organization Active NPI

Geriatric Solutions, LLC

  • Internal Medicine Physician
  • Fort Pierce, FL
National Provider Identifier
1073839718
Registry record updated Dec 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
GERIATRIC SOLUTIONS, LLC
Practice address
5804 Indian Pines Blvd
Fort Pierce, FL 34951-2302
Phone
(772) 828-3752
Fax
(772) 302-3518
NPI assigned
Apr 19, 2010
Last updated
Dec 2, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2022

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

Authorized official

Name
Mrs. Madetric Nafaye Wood, ARNP, GNP-BCNPI 1073716650
Title
Geriatric Nurse Practitioner
Phone
(850) 322-1895

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU
Health Service Clinic/Center 261QH0100X NU
Medical Specialty Clinic/Center 261QM2500X NU
Primary Care Clinic/Center 261QP2300X NU
Gerontology Nurse Practitioner 363LG0600X NU
Adult Medicine Physician 207QA0505X NU
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

5804 Indian Pines Blvd
Fort Pierce, FL 34951-2302

Mailing address

5804 Indian Pines Blvd
Fort Pierce, FL 34951-2302
Phone (772) 828-3752

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100629000989 FL Part B Supplier - Clinic/Group Practice 4587795810 Receives reassigned benefits from 4 practitioners
Practice locations: Vero Beach, FL; Port Saint Lucie, FL; Fort Pierce, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2166226Geriatric Solutions5804 Indian Pines Blvd, Fort Pierce, FL 34951Certificate of waiverMay 13, 2027

National Provider Directory

National Provider Directory

Locations

5804 Indian Pines Blvd
Fort Pierce, FL 34951
Phone (772) 203-1887

709 S 5th St
Fort Pierce, FL 34950
Phone (772) 468-5610

8483 S US Highway 1
Port St Lucie, FL 34952
Phone (772) 873-1770

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1271635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669939200000",
    "number": "1073839718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5804 INDIAN PINES BLVD",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349512302",
            "telephone_number": "772-828-3752",
            "fax_number": "772-302-3518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5804 INDIAN PINES BLVD",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349512302",
            "telephone_number": "772-828-3752",
            "fax_number": "772-302-3518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERIATRIC SOLUTIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-19",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "MADETRIC",
        "authorized_official_middle_name": "NAFAYE",
        "authorized_official_title_or_position": "GERIATRIC NURSE PRACTITIONER",
        "authorized_official_telephone_number": "850-322-1895",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "ARNP, GNP-BC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.