Individual provider Active NPI

Emily Claire Sack, ARNP

  • Adult Health Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1104284926
Registry record updated Feb 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
9318736 Issued in FL
Practice address
1201 Orient Rd
Tampa, FL 33619-3325
Phone
(813) 247-0805
NPI assigned
Feb 8, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 9318736 FL Primary

Addresses

Primary practice location

1201 Orient Rd
Tampa, FL 33619-3325

Mailing address

2090 Columbiana Rd Ste 4000
Vestavia, AL 35216-2158

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
I20161026001966 FL Practitioner - Nurse Practitioner 9234417262 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paragon Contracting Services LLCGroup PAC ID 3971417825, 404 clinicians
Paragon Emergency Services LLCGroup PAC ID 8628153087, 401 clinicians

Practice addresses (Care Compare)

200 Ave F NE
Winter Haven, FL 33881-4131
Phone (863) 297-1800

Hospital & facility affiliations

  • Winter Haven Hospital Hospital, Winter Haven, FL, CCN 100052

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9318736FLMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Emergency Services LLC CurrentSince Oct 1, 2016 Accepting new patients
Paragon Contracting Services LLC CurrentSince Jul 5, 2018 Accepting new patients

Locations

3625 University Blvd S
Jacksonville, FL 32216
Phone (904) 333-9404

200 Avenue F NE
Winter Haven, FL 33881
Phone (863) 292-4652

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 1

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": "1454889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454889600000",
    "number": "1104284926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2090 COLUMBIANA RD STE 4000",
            "city": "VESTAVIA",
            "state": "AL",
            "postal_code": "352162158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 ORIENT RD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336193325",
            "telephone_number": "813-247-0805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SACK",
        "first_name": "EMILY",
        "middle_name": "CLAIRE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-08",
        "last_updated": "2016-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "9318736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.