Individual provider Active NPI

Roan Cadavona, ARNP

  • Family Nurse Practitioner
  • Winter Haven, FL
National Provider Identifier
1093206104
Registry record updated May 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F05180059 Issued in FL
Practice address
1601 6TH St SE
Winter Haven, FL 33880-4605
Phone
(863) 419-9301
NPI assigned
May 24, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F05180059 FL Primary

Addresses

Primary practice location

1601 6TH St SE
Winter Haven, FL 33880-4605

Mailing address

303 Terranova Blvd
Winter Haven, FL 33884-3427
Phone (863) 298-9035

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
I20191106002959 FL Practitioner - Nurse Practitioner 3870843931 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F05180059FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Messieh Orthopedic Clinic PA CurrentSince Jun 4, 2018 Accepting new patients

Locations

1601 6th St SE
Winter Haven, FL 33880
Phone (863) 294-0350

Interoperability endpoints

  • Direct secure messaging: roan.cadavona@kscc.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/BEJADA/Endpoint/BEJADA

Organizations & group practices 1

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": "1527120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527120000000",
    "number": "1093206104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 TERRANOVA BLVD",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338843427",
            "telephone_number": "863-298-9035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 6TH ST SE",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338804605",
            "telephone_number": "863-419-9301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CADAVONA",
        "first_name": "ROAN",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-24",
        "last_updated": "2018-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "F05180059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

Verify at the official NPI Registry.