Individual provider Active NPI

Nerida Consuelo Nieves, ARNP

  • Family Nurse Practitioner
  • Lakeland, FL
National Provider Identifier
1104332790
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9303022 Issued in FL
Practice address
2815 Lakeland Hills Blvd
Lakeland, FL 33805-2224
Phone
(863) 284-5000
Fax
(863) 284-6904
NPI assigned
Dec 19, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN9303022 FL
Family Nurse Practitioner 363LF0000X ARNP9303022 FL Primary

Addresses

Primary practice location

2815 Lakeland Hills Blvd
Lakeland, FL 33805-2224

Mailing address

1324 Lakeland Hills Blvd
Managed Care Dept
Lakeland, FL 33805

Other practice location 1

2352 Bruce B Downs Blvd Ste 204
Wesley Chapel, FL 33544-9203
Phone (813) 994-1286

Other identifiers 1

IdentifierTypeStateIssuer
023740200MedicaidFL

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
I20180126000362 FL Practitioner - Nurse Practitioner 7113286899 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeland Regional Health Systems IncGroup PAC ID 8325952914, 513 clinicians

Practice addresses (Care Compare)

2815 Lakeland Hills Blvd
Lakeland, FL 33805-2224
Phone (863) 284-6900

Hospital & facility affiliations

  • Lakeland Regional Medical Center Hospital, Lakeland, FL, CCN 100157

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN9303022FLMDFamily Nurse Practitioner
ARNP9303022FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Medical Clinic LLC CurrentSince Jan 2, 2018 Accepting new patients
Lakeland Regional Health Systems, Inc. CurrentSince Jul 1, 2020 Accepting new patients
Florida Medical Clinic, LLC CurrentSince Jan 2, 2018 Accepting new patients
Lakeland Regional Health Systems, Inc. PastSince May 10, 2020 Accepting new patients

Locations

2815 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 284-6900

3525 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 603-6565

1324 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 687-1132

38135 Market Square Dr
Zephyrhills, FL 33542
Phone (352) 567-0188

Interoperability endpoints

  • Direct secure messaging: nnieves18072@lrhs.direct-ci.com

Organizations & group practices 4

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": "1513641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1104332790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 LAKELAND HILLS BLVD",
            "address_2": "MANAGED CARE DEPT",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "33805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2815 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338052224",
            "telephone_number": "863-284-5000",
            "fax_number": "863-284-6904"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2352 Bruce B Downs Blvd Ste 204",
            "address_purpose": "LOCATION",
            "city": "Wesley Chapel",
            "state": "FL",
            "postal_code": "335449203",
            "country_code": "US",
            "telephone_number": "813-994-1286",
            "fax_number": "813-355-5031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIEVES",
        "first_name": "NERIDA",
        "middle_name": "CONSUELO",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-19",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9303022",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9303022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "023740200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.