Individual provider Active NPI

Gina Renea Fann, APRN

  • Family Nurse Practitioner
  • Winter Haven, FL
National Provider Identifier
1114646189
Registry record updated Feb 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11021031 Issued in FL
Practice address
325 1St St N
Winter Haven, FL 33881-4111
Phone
(863) 293-1191
Fax
(863) 293-7901
NPI assigned
Aug 24, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2026

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 APRN11021031 FL Primary

Addresses

Primary practice location

325 1St St N
Winter Haven, FL 33881-4111

Mailing address

500 E Central Ave
Winter Haven, FL 33880-3094
Phone (863) 293-1191

Other identifiers 1

IdentifierTypeStateIssuer
117296300MedicaidFL

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
I20221003001857 FL Practitioner - Nurse Practitioner 0749666584 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adventhealth Bond Clinic, Inc.Group PAC ID 2264931294, 87 clinicians

Practice addresses (Care Compare)

325 1St St N
Winter Haven, FL 33881-4411
Phone (863) 293-1191

Hospital & facility affiliations

  • Winter Haven Hospital Hospital, Winter Haven, FL, CCN 100052

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11021031FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Adventhealth Bond Clinic, Inc. CurrentSince Jul 1, 2025 Accepting new patients
Bond Clinic PA CurrentSince Sep 6, 2022 Accepting new patients
Bond Clinic PA CurrentSince Sep 6, 2022 Accepting new patients
Adventhealth Bond Clinic, Inc. CurrentSince Jul 1, 2025 Accepting new patients
Bond Urgent Care LLC Past Accepting new patients

Locations

325 1st St N
Winter Haven, FL 33881

500 E Central Ave
Winter Haven, FL 33880
Phone 86329311913286

Interoperability endpoints

  • Direct secure messaging: gina.fann.p1@direct.bondclinicpa.nextgenshare.com

Organizations & group practices 5

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 1

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": "1661299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770508800000",
    "number": "1114646189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 E CENTRAL AVE",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338803094",
            "telephone_number": "863-293-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 1ST ST N",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338814111",
            "telephone_number": "863-293-1191",
            "fax_number": "863-293-7901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANN",
        "first_name": "GINA",
        "middle_name": "RENEA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-24",
        "last_updated": "2026-02-08",
        "certification_date": "2026-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11021031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117296300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

Verify at the official NPI Registry.