Individual provider Active NPI

Elaine Robertson, ARNP

  • Nurse Practitioner
  • Maitland, FL
National Provider Identifier
1073932703
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN3228952 Issued in FL
Practice address
2201 Lucien Way Ste 200
Maitland, FL 32751-7003
Phone
(877) 868-4827
NPI assigned
Apr 9, 2014
Last updated
Mar 30, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN3228952 FL Primary

Addresses

Primary practice location

2201 Lucien Way Ste 200
Maitland, FL 32751-7003

Mailing address

2201 Lucien Way Ste 200
Maitland, FL 32751-7003

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address referral@vitas.direct.kno2fy.com VITAS Solutions Inc

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN3228952FLMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1397001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1073932703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 LUCIEN WAY STE 200",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 LUCIEN WAY STE 200",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517003",
            "telephone_number": "877-868-4827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "ELAINE",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-09",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN3228952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "referral@vitas.direct.kno2fy.com",
            "affiliation": "Y",
            "affiliationName": "VITAS Solutions Inc",
            "address_1": "3720 Executive Way",
            "city": "Miramar",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330253946",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Maitland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; 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.