NPIMap

Organization Active NPI

Impower, Inc

  • Community/Behavioral Health Agency
  • Longwood, FL
National Provider Identifier
1104910868
Registry record updated Jul 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
IMPOWER, INC
Practice address
2290 N Ronald Reagan Blvd Ste 116
Longwood, FL 32750-3534
Phone
(407) 331-8002
Fax
(407) 331-8659
NPI assigned
Oct 3, 2006
Last updated
Jul 21, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2026

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

Authorized official

Name
Jamie Nau
Title
Credenitaling Specialist
Phone
(689) 686-4665

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Special Hospital 284300000X NU
Substance Abuse Rehabilitation Facility 324500000X NU
Children's Substance Abuse Rehabilitation Facility 3245S0500X NU
Medical Physician Assistant 363AM0700X NU
Counselor 101Y00000X NU
Child & Adolescent Psychiatry Physician 2084P0804X NU
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

2290 N Ronald Reagan Blvd Ste 116
Longwood, FL 32750-3534

Mailing address

2290 N Ronald Reagan Blvd Ste 116
Longwood, FL 32750-3534
Phone (407) 215-0095

Other practice location 1

808 W Central Blvd
Orlando, FL 32805-1809
Phone (407) 215-0095

Other practice location 2

580 Old Sanford Oviedo Rd
Winter Springs, FL 32708-2637
Phone (407) 331-8002

Other identifiers 11

IdentifierTypeStateIssuer
006714200MedicaidFL
005979100MedicaidFL
360212502MedicaidFL
759027000MedicaidFL
360212505MedicaidFL
006714203MedicaidFL
360212500MedicaidFL
006714201MedicaidFL
013827000MedicaidFL
006714202MedicaidFL
007186500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081015000736 FL Part B Supplier - Clinic/Group Practice 6507924883 Receives reassigned benefits from 12 practitioners
Practice locations: Longwood, FL; Winter Springs, FL

National Provider Directory

National Provider Directory
Tax ID family
Impower Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

804 N Hoagland Blvd
Kissimmee, FL 34741
Phone (407) 797-7298

2290 N Ronald Reagan Blvd
Ste 116
Longwood, FL 32750
Phone (407) 215-0095

1037 Pathfinder Way
Ste 130
Rockledge, FL 32955
Phone (321) 243-3376

1037 Pathfinder Way
Ste 3
Rockledge, FL 32955
Phone (321) 751-0155

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 90

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 90

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784592000000",
    "number": "1104910868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2290 N RONALD REAGAN BLVD STE 116",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327503534",
            "telephone_number": "407-215-0095",
            "fax_number": "407-261-0523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2290 N RONALD REAGAN BLVD STE 116",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327503534",
            "telephone_number": "407-331-8002",
            "fax_number": "407-331-8659"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "808 W Central Blvd",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328051809",
            "country_code": "US",
            "telephone_number": "407-215-0095",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "580 Old Sanford Oviedo Rd",
            "address_purpose": "LOCATION",
            "city": "Winter Springs",
            "state": "FL",
            "postal_code": "327082637",
            "country_code": "US",
            "telephone_number": "407-331-8002",
            "fax_number": "407-331-8659",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "IMPOWER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A",
        "authorized_official_last_name": "NAU",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "CREDENITALING SPECIALIST",
        "authorized_official_telephone_number": "689-686-4665"
    },
    "taxonomies": [
        {
            "code": "284300000X",
            "taxonomy_group": "",
            "desc": "Special Hospital",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006714200",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005979100",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "360212502",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "759027000",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "360212505",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006714203",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "360212500",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006714201",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "013827000",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006714202",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007186500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longwood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.