Individual provider Active NPI

Carly Anne Schroeder, APRN

  • Family Nurse Practitioner
  • New Port Richey, FL
National Provider Identifier
1114760121
Registry record updated Jul 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11040847 Issued in FL
Practice address
6804 Cecelia Dr
New Port Richey, FL 34653-4935
Phone
(855) 232-0644
Fax
(888) 546-0488
NPI assigned
Jun 17, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Intensive Care Registered Nurse 163WN0002X 9530122 FL
Family Nurse Practitioner 363LF0000X APRN11040847 FL Primary

Addresses

Primary practice location

6804 Cecelia Dr
New Port Richey, FL 34653-4935

Mailing address

6804 Cecelia Dr
New Port Richey, FL 34653-4935
Phone (855) 232-0644

Other practice location 1

9981 S Healthpark Dr
Fort Myers, FL 33908-3618
Phone (239) 343-5437

Other identifiers 1

IdentifierTypeStateIssuer
127924600MedicaidFL

Other names 1

  • Carly Anne Sansoucy Former name

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
I20250805003369 FL Practitioner - Nurse Practitioner 5890203301 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dispatchhealth-Florida Inc.Group PAC ID 2668899220, 36 clinicians

Practice addresses (Care Compare)

8270 College Pkwy
Suite 103
Fort Myers, FL 33919-5106
Phone (303) 904-7240

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9530122FLMDNeonatal Intensive Care Registered Nurse
APRN11040847FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Health System Inc CurrentSince Feb 1, 2026 Accepting new patients
Dispatchhealth-Florida Inc. CurrentSince Jul 28, 2025 Accepting new patients
Lee Health System Inc CurrentSince Feb 1, 2026 Accepting new patients

Locations

1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

8270 College Pkwy
Ste 103
Fort Myers, FL 33919
Phone (239) 322-3434

9981 S Healthpark Dr
Fort Myers, FL 33908
Phone (239) 332-5344

3347 NW 55th St
Ft Lauderdale, FL 33309
Phone (754) 900-1979

3200 SW 34th Ave
Ste 702
Ocala, FL 34474

5421 Beaumont Center Blvd
Ste 660
Tampa, FL 33634
Phone (813) 551-1015

Interoperability endpoints

  • Direct secure messaging: cschroeder704826@direct.leememorial.org
  • Direct secure messaging: carly.schroeder.1@13869.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1718582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785369600000",
    "number": "1114760121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6804 CECELIA DR",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346534935",
            "telephone_number": "855-232-0644",
            "fax_number": "888-546-0488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6804 CECELIA DR",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346534935",
            "telephone_number": "855-232-0644",
            "fax_number": "888-546-0488"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9981 S Healthpark Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339083618",
            "country_code": "US",
            "telephone_number": "239-343-5437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHROEDER",
        "first_name": "CARLY",
        "middle_name": "ANNE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-17",
        "last_updated": "2026-07-30",
        "certification_date": "2026-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WN0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal Intensive Care",
            "state": "FL",
            "license": "9530122",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11040847",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127924600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLY",
            "last_name": "SANSOUCY",
            "middle_name": "ANNE",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New Port Richey, FL

Sources for this page

Verify at the official NPI Registry.