Individual provider Active NPI

Annie Varghese Thomas, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1124736699
Registry record updated Apr 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN11022929 Issued in FL
Practice address
2345 Sand Lake Rd Ste 200
Orlando, FL 32809-9140
Phone
(407) 329-6599
NPI assigned
Nov 14, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11022929 FL Primary

Addresses

Primary practice location

2345 Sand Lake Rd Ste 200
Orlando, FL 32809-9140

Mailing address

2345 Sand Lake Rd Ste 200
Orlando, FL 32809-9140
Phone (407) 329-6599

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
I20240227003608 FL Practitioner - Nurse Practitioner 4688019862 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11022929FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Psychiatric/Mental Health CurrentSince Jan 23, 2024 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 1

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": "1668384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680307200000",
    "number": "1124736699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2345 SAND LAKE RD STE 200",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328099140",
            "telephone_number": "407-329-6599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2345 SAND LAKE RD STE 200",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328099140",
            "telephone_number": "407-329-6599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "ANNIE",
        "middle_name": "VARGHESE",
        "name_prefix": "Mrs.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-14",
        "last_updated": "2023-04-01",
        "certification_date": "2023-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11022929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.