Individual provider Active NPI

Mary-Ellen Macdonald, FNP

  • Nurse Practitioner
  • Crystal River, FL
National Provider Identifier
1114205200
Registry record updated Apr 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP9421749 Issued in FL
Practice address
6038 W Nordling Loop
Crystal River, FL 34429-8715
Phone
(352) 563-5070
Fax
(352) 795-4322
NPI assigned
Jul 25, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP9421749 FL Primary

Addresses

Primary practice location

6038 W Nordling Loop
Crystal River, FL 34429-8715

Mailing address

105 Pine Street
Homosassa, FL 34446-5201
Phone (207) 942-6226

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
I20160922001140 FL Practitioner - Nurse Practitioner 0840460481 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Internal Medicine and Pediatrics Wellness Center 6 clinicians

Practice addresses (Care Compare)

6038 W Nordling Loop
Crystal River, FL 34429-8715
Phone (352) 563-5070

Hospital & facility affiliations

  • HCA Florida Citrus Hospital Hospital, Inverness, FL, CCN 100023
  • Tampa General Hospital Crystal River Hospital, Crystal River, FL, CCN 100249

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9421749FLMDNurse Practitioner

Practice roles (4 of 5)

OrganizationSpecialtyStatusNew patients
Quality Healthcare Services PLLC CurrentSince Jan 2, 2019 Accepting new patients
Internal Medicine & Pediatrics Wellness Center CurrentSince Jul 12, 2016 Accepting new patients
Sunbury Primary Care, P.a. Past Accepting new patients
Sunbury Primary Care, P.a. Past Accepting new patients

Locations

6038 W Nordling Loop
Crystal River, FL 34429
Phone (352) 563-5070

6026 W Nordling Loop
Crystal River, FL 34429
Phone (352) 354-4476

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22703/brand/1/csg/1/fhir/r4
  • Direct secure messaging: mary-ellen.macdonald.1@22703.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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": "1311552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461283200000",
    "number": "1114205200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 PINE STREET",
            "city": "HOMOSASSA",
            "state": "FL",
            "postal_code": "344465201",
            "telephone_number": "207-942-6226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6038 W NORDLING LOOP",
            "city": "CRYSTAL RIVER",
            "state": "FL",
            "postal_code": "344298715",
            "telephone_number": "352-563-5070",
            "fax_number": "352-795-4322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACDONALD",
        "first_name": "MARY-ELLEN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-25",
        "last_updated": "2016-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9421749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal River, FL

Sources for this page

Verify at the official NPI Registry.