NPIMap

Individual provider Active NPI

John Antonio Santos, FNP-BC

  • Family Nurse Practitioner
  • Wildwood, FL
National Provider Identifier
1114160272
Registry record updated Mar 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9249583 Issued in FL
Practice address
4669 E Sr 44 Ste 1
Wildwood, FL 34785-7460
Phone
(352) 399-7301
Fax
(352) 792-1051
NPI assigned
Apr 19, 2009
Last updated
Mar 29, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2023

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 ARNP9249583 FL Primary

Addresses

Primary practice location

4669 E Sr 44 Ste 1
Wildwood, FL 34785-7460

Mailing address

4669 E Sr 44 Ste 1
Wildwood, FL 34785-7460
Phone (352) 399-7301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090610000040 FL Practitioner - Nurse Practitioner 1951451145 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Washington University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cora Health Services IncGroup PAC ID 1759290992, shared by 21 NPIs, 1,125 clinicians
Vizavee Urgent and Primary Care, LLCGroup PAC ID 1557764784, 15 clinicians

Practice addresses (Care Compare)

1050 Old Camp Rd
Suite 282
The Villages, FL 32162-1762
Phone (352) 693-3378

2953 Traverse TRL
The Villages, FL 32163-2017
Phone (352) 693-3378

4669 E Sr
44 Suite 101
Wildwood, FL 34785-7460
Phone (352) 399-7301

8768 SE 165TH Mulberry LN
Cora Physical Therapy Mulberry Lane
The Villages, FL 32162-5861
Phone (352) 329-5237

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Vizavee Urgent & Primary Care, LLC CurrentSince Aug 1, 2021 Accepting new patients
Dolphin Emergency Physicians LLC Past Accepting new patients
Florida Em-I Medical Services PA Past Accepting new patients

Locations

340 Heald Way
Ste 208
The Villages, FL 32163
Phone (352) 259-5762

910 Old Camp Rd
Ste 114
The Villages, FL 32162
Phone (352) 259-4322

4669 E State Road 44
Ste 101
Wildwood, FL 34785
Phone (352) 399-7301

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24264/brand/1/csg/1/fhir/r4
  • Direct secure messaging: john.santos.1@24264.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1240099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1114160272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4669 E SR 44 STE 1",
            "city": "WILDWOOD",
            "state": "FL",
            "postal_code": "347857460",
            "telephone_number": "352-399-7301",
            "fax_number": "352-792-1051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4669 E SR 44 STE 1",
            "city": "WILDWOOD",
            "state": "FL",
            "postal_code": "347857460",
            "telephone_number": "352-399-7301",
            "fax_number": "352-792-1051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTOS",
        "first_name": "JOHN",
        "middle_name": "ANTONIO",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-19",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9249583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wildwood, FL

Sources for this page

Verify at the official NPI Registry.