Individual provider Active NPI

Dane Huge, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Daytona Beach, FL
National Provider Identifier
1104464882
Registry record updated Dec 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN11004716 Issued in FL
Practice address
1150 Red John Dr
Daytona Beach, FL 32124-1016
Phone
(800) 539-4228
NPI assigned
Dec 13, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X APRN11004716 FL Primary

Addresses

Primary practice location

1150 Red John Dr
Daytona Beach, FL 32124-1016

Mailing address

150 Magnolia Ave
Daytona Beach, FL 32114-4304
Phone (800) 539-4228

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
I20200204002850 FL Practitioner - Nurse Practitioner 6204262579 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sma Healthcare, Inc Multi-Specialty CurrentSince Dec 11, 2019 Accepting new patients
Sma Healthcare Inc Multi-Specialty CurrentSince Dec 11, 2019 Accepting new patients

Locations

301 Justice Ln
Bunnell, FL 32110
Phone (386) 236-1726

1150 Red John Dr
Daytona Beach, FL 32124
Phone (386) 236-3183

150 Magnolia Ave
Daytona Beach, FL 32114
Phone (386) 236-3215

1220 Willis Ave
Daytona Beach, FL 32114
Phone (386) 236-3200

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1576195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576195200000",
    "number": "1104464882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 MAGNOLIA AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321144304",
            "telephone_number": "800-539-4228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 RED JOHN DR",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321241016",
            "telephone_number": "800-539-4228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUGE",
        "first_name": "DANE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-12-13",
        "last_updated": "2019-12-13",
        "certification_date": "2019-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11004716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.