Individual provider Active NPI

Nina Frances Gossman

  • Family Nurse Practitioner
  • Orange City, FL
National Provider Identifier
1104354703
Registry record updated Jun 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9287561 Issued in FL
Practice address
2400 Enterprise Rd
Orange City, FL 32763-7902
Phone
(866) 389-2727
NPI assigned
May 25, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2020

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 9287561 FL Primary

Addresses

Primary practice location

2400 Enterprise Rd
Orange City, FL 32763-7902

Mailing address

2400 Enterprise Rd
Orange City, FL 32763-7902
Phone (866) 389-2727

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
I20170920003451 FL Practitioner - Nurse Practitioner 1355615964 Reassigns benefits to 1 organization

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
Minuteclinic LLCGroup PAC ID 6709850241, 576 clinicians

Practice addresses (Care Compare)

2400 Enterprise Rd
Orange City, FL 32763-7902
Phone (866) 389-2727

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9287561FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic LLC Family CurrentSince Jul 13, 2017 Accepting new patients

Locations

121 W Macclenny Ave
Macclenny, FL 32063
Phone (904) 259-6380

12401 Miramar Pkwy
Miramar, FL 33027
Phone (954) 538-8473

2400 Enterprise Rd
Orange City, FL 32763
Phone (386) 775-7770

8765 S Dixie Hwy
Pinecrest, FL 33156
Phone (305) 740-6840

7599 W Sand Lake Rd
Sand Lake, FL 32819
Phone (407) 352-0943

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

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": "1495670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592870400000",
    "number": "1104354703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 ENTERPRISE RD",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327637902",
            "telephone_number": "866-389-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 ENTERPRISE RD",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327637902",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOSSMAN",
        "first_name": "NINA",
        "middle_name": "FRANCES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-25",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9287561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange City, FL

Sources for this page

Verify at the official NPI Registry.