Individual provider Active NPI

Stephanie Adele Scudiero, NP

  • Family Nurse Practitioner
  • Largo, FL
National Provider Identifier
1104479757
Registry record updated Mar 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F07190641 Issued in FL
Practice address
947 Nolan Dr
Largo, FL 33770-4380
Phone
(727) 479-6840
Fax
(865) 409-5904
NPI assigned
Jul 23, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN9379320 FL
Family Nurse Practitioner 363LF0000X F07190641 FL Primary

Addresses

Primary practice location

947 Nolan Dr
Largo, FL 33770-4380

Mailing address

947 Nolan Dr
Largo, FL 33770-4380
Phone (727) 479-6840

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
I20200903001700 FL Practitioner - Nurse Practitioner 0042637118 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN9379320FLMDRegistered Nurse
F07190641FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Medical Center of Florida, LLC. CurrentSince Aug 24, 2020 Accepting new patients
West Coast Ear, Nose & Throat Inc CurrentSince Jul 28, 2019 Accepting new patients
Gulfcoast Spinal Center, Inc. PastSince Aug 24, 2020 Accepting new patients

Locations

7136 Little Rd
New Prt Rchy, FL 34654
Phone (727) 816-9616

11320 State Road 54
Trinity, FL 34655
Phone (727) 247-1234

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1528

Organizations & group practices 3

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": "1563840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773273600000",
    "number": "1104479757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "947 NOLAN DR",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337704380",
            "telephone_number": "727-479-6840",
            "fax_number": "865-409-5904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "947 NOLAN DR",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337704380",
            "telephone_number": "727-479-6840",
            "fax_number": "865-409-5904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCUDIERO",
        "first_name": "STEPHANIE",
        "middle_name": "ADELE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-23",
        "last_updated": "2026-03-12",
        "certification_date": "2026-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9379320",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "F07190641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

Verify at the official NPI Registry.