Individual provider Active NPI

Julie Root, RN

  • Emergency Registered Nurse
  • Mary Esther, FL
National Provider Identifier
1104641125
Registry record updated Nov 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Registered NurseTaxonomy code 163WE0003X
License
9280243 Issued in FL
Practice address
606 Lakeview St
Mary Esther, FL 32569-2761
Phone
(850) 218-8510
NPI assigned
Nov 15, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X 95309053 CA
Emergency Registered Nurse 163WE0003X 215661 AK
Emergency Registered Nurse 163WE0003X RN-115840-0 HI
Emergency Registered Nurse 163WE0003X 202206153RN OR
Emergency Registered Nurse 163WE0003X 9280243 FL Primary

Addresses

Primary practice location

606 Lakeview St
Mary Esther, FL 32569-2761

Mailing address

606 Lakeview St
Mary Esther, FL 32569-2761
Phone (850) 218-8510

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
215661AKMDEmergency Registered Nurse
95309053CAMDEmergency Registered Nurse
9280243FLMDEmergency Registered Nurse
RN-115840-0HIMDEmergency Registered Nurse
202206153RNORMDEmergency Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1731628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1104641125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 LAKEVIEW ST",
            "city": "MARY ESTHER",
            "state": "FL",
            "postal_code": "325692761",
            "telephone_number": "850-218-8510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 LAKEVIEW ST",
            "city": "MARY ESTHER",
            "state": "FL",
            "postal_code": "325692761",
            "telephone_number": "850-218-8510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROOT",
        "first_name": "JULIE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-15",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "CA",
            "license": "95309053",
            "primary": false
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "AK",
            "license": "215661",
            "primary": false
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "HI",
            "license": "RN-115840-0",
            "primary": false
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "OR",
            "license": "202206153RN",
            "primary": false
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "FL",
            "license": "9280243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mary Esther, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.