Individual provider Active NPI

Lauren Cathryn Endick, ARNP

  • Nurse Practitioner
  • Valrico, FL
National Provider Identifier
1093016784
Registry record updated Dec 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP9186796 Issued in FL
Practice address
2553 Mason Oaks Dr
Valrico, FL 33596-6498
Phone
(813) 940-6046
Fax
(866) 451-4607
NPI assigned
Nov 11, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2020

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 ARNP9186796 FL Primary

Addresses

Primary practice location

2553 Mason Oaks Dr
Valrico, FL 33596-6498

Mailing address

2553 Mason Oaks Dr
Valrico, FL 33596-6498
Phone (813) 940-6046

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
I20121220000081 FL Practitioner - Nurse Practitioner 9830341866 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1114 Chatman Blvd
Brooksville, FL 34601-3104
Phone (352) 796-6701

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ARNP9186796FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Keys2Health LLC CurrentSince Aug 1, 2020 Accepting new patients
Jan D. Phelps, PA PastSince Dec 13, 2020 Accepting new patients

Locations

1114 Chatman Blvd
Brooksville, FL 34601
Phone (352) 796-6701

38220 Henry Dr
Zephyrhills, FL 33542
Phone (813) 788-6903

Organizations & group practices 2

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 3

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": "1289433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607385600000",
    "number": "1093016784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2553 MASON OAKS DR",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "335966498",
            "telephone_number": "813-940-6046",
            "fax_number": "866-451-4607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2553 MASON OAKS DR",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "335966498",
            "telephone_number": "813-940-6046",
            "fax_number": "866-451-4607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENDICK",
        "first_name": "LAUREN",
        "middle_name": "CATHRYN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-11",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9186796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valrico, FL

Sources for this page

Verify at the official NPI Registry.