Individual provider Active NPI

Brenda L. Hart, FNP-C, CRNP, CWON

  • Family Nurse Practitioner
  • Daytona Beach, FL
National Provider Identifier
1114472834
Registry record updated May 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN2963932 Issued in FL
Practice address
311 N Clyde Morris Blvd
Daytona Beach, FL 32114-2781
Phone
(386) 425-4267
Fax
(386) 425-4879
NPI assigned
Aug 23, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 2963932 FL
Family Nurse Practitioner 363LF0000X 2963932 FL
Family Nurse Practitioner 363LF0000X AC002610 MD
Family Nurse Practitioner 363LF0000X APRN2963932 FL Primary

Addresses

Primary practice location

311 N Clyde Morris Blvd
Daytona Beach, FL 32114-2781

Mailing address

303 N Clyde Morris Blvd
Daytona Beach, FL 32114-2709

Other practice location 1

2001 Medical Pkwy Fl 1
Annapolis, MD 21401-3795
Phone (443) 481-5187

Other practice location 2

1041 Dunlawton Ave
Port Orange, FL 32127-7968
Phone (386) 425-2285

Other practice location 3

1244 Golden Canna Ln
Celebration, FL 34747-4009
Phone (813) 727-0415

Other practice location 4

303 N Clyde Morris Blvd
Daytona Beach, FL 32114-2709
Phone (941) 820-0053

Other identifiers 1

IdentifierTypeStateIssuer
805100OtherMDMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170203001866 FL Practitioner - Nurse Practitioner 7214210970 Reassigns benefits to 3 organizations
I20190529000659 MD Practitioner - Nurse Practitioner 7214210970 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nautilus Health Care Group LLCGroup PAC ID 5991604852, 51 clinicians

Practice addresses (Care Compare)

2040 Oakley Seaver Dr
Suite 200
Clermont, FL 34711-1962
Phone (855) 689-2102

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.45 of 100Reported as group
Quality
67.28
Promoting interoperability
98
Improvement activities
40
Cost
72.57

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2963932FLMDFamily Nurse Practitioner
APRN2963932FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Renew Wound Care of Florida LLC CurrentSince Mar 15, 2023 Accepting new patients
Luminis Health Medical Group, LLC Current Accepting new patients
Nautilus Health Care Group LLC Current Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Mar 31, 2019 Accepting new patients
Nautilus Health Care Group, LLC CurrentSince Aug 1, 2023 Accepting new patients
Halifax Healthcare Systems Inc CurrentSince May 10, 2022 Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Mar 31, 2019 Accepting new patients
Advanced Wound Systems LLC Past Accepting new patients

Locations

2040 Oakley Seaver Dr
Ste 200
Clermont, FL 34711
Phone (352) 536-8788

151 E Redstone Ave
Crestview, FL 32539
Phone (850) 629-8515

311 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 241-1020

303 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 425-2285

3648 University Blvd S
Jacksonville, FL 32216
Phone (904) 345-7185

1500 Lee Blvd
Lehigh Acres, FL 33936
Phone (239) 368-4410

1041 Dunlawton Ave
Pt Orange, FL 32127
Phone (386) 322-4700

1120 Pinellas Bayway S
Ste 200
Tierra Verde, FL 33715
Phone (727) 867-5480

2001 Medical Pkwy
Fl 1
Annapolis, MD 21401
Phone (443) 481-5187

2003 Medical Pkwy
Ste 301
Annapolis, MD 21401
Phone (443) 481-3366

2001 Medical Pkwy
Annapolis, MD 21401
Phone (410) 280-5601

1481 McDonald Ave
Brooklyn, NY 11230
Phone (347) 479-1110

Interoperability endpoints

  • Direct secure messaging: bhart70174@direct.aahs.org

Organizations & group practices 8

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 5

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": "1471910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652313600000",
    "number": "1114472834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 N CLYDE MORRIS BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 N CLYDE MORRIS BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142781",
            "telephone_number": "386-425-4267",
            "fax_number": "386-425-4879"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2001 Medical Pkwy Fl 1",
            "address_purpose": "LOCATION",
            "city": "Annapolis",
            "state": "MD",
            "postal_code": "214013795",
            "country_code": "US",
            "telephone_number": "443-481-5187",
            "fax_number": "443-481-5198",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1041 Dunlawton Ave",
            "address_purpose": "LOCATION",
            "city": "Port Orange",
            "state": "FL",
            "postal_code": "321277968",
            "country_code": "US",
            "telephone_number": "386-425-2285",
            "fax_number": "386-425-7522",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1244 Golden Canna Ln",
            "address_purpose": "LOCATION",
            "city": "Celebration",
            "state": "FL",
            "postal_code": "347474009",
            "country_code": "US",
            "telephone_number": "813-727-0415",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "303 N Clyde Morris Blvd",
            "address_purpose": "LOCATION",
            "city": "Daytona Beach",
            "state": "FL",
            "postal_code": "321142709",
            "country_code": "US",
            "telephone_number": "941-820-0053",
            "fax_number": "941-748-8894",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HART",
        "first_name": "BRENDA",
        "middle_name": "L.",
        "credential": "FNP-C, CRNP, CWON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-23",
        "last_updated": "2022-05-12",
        "certification_date": "2022-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "2963932",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "2963932",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "AC002610",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN2963932",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "805100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.