Individual provider Active NPI

Charity Hallahan, APRN

  • Acute Care Nurse Practitioner
  • Gainesville, FL
National Provider Identifier
1114776606
Registry record updated May 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
APRN11032784 Issued in FL
Practice address
1515 SW Archer Rd
Gainesville, FL 32608-1134
Phone
(352) 265-0111
NPI assigned
May 16, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X APRN11032784 FL Primary

Addresses

Primary practice location

1515 SW Archer Rd
Gainesville, FL 32608-1134

Mailing address

413 S Westmoreland St
Starke, FL 32091-3850
Phone (352) 359-4793

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
I20240623000043 FL Practitioner - Nurse Practitioner 4688117385 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc CurrentSince Jun 17, 2024 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Jun 17, 2024 Accepting new patients

Locations

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

1515 SW Archer Rd
Gainesville, FL 32608
Phone (352) 265-0916

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: cjohns123305@direct.shands.ufl.edu

Organizations & group practices 2

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": "1715817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1114776606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 S WESTMORELAND ST",
            "city": "STARKE",
            "state": "FL",
            "postal_code": "320913850",
            "telephone_number": "352-359-4793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326081134",
            "telephone_number": "352-265-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLAHAN",
        "first_name": "CHARITY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-16",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "APRN11032784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.