Andrea Nicholas, ARNP
Individual provider Active NPI Gerontology Nurse Practitioner · Holmes Beach, FL
NPI 1134570930 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1134570930
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Gerontology Nurse Practitioner 363LG0600X
- License
- ARNP 2854132 (FL)
- Practice address
- 209 82ND Street
Holmes Beach, FL 34217 - Phone
- (941) 545-1296
- Fax
- (941) 761-6580
- NPI assigned
- Jun 23, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
11005 Bristol Bay Dr
Apt 605
Bradenton, FL 34209-7901
Phone (941) 545-1296
Hospital & facility affiliations
- Southwest Florida Home Care Inc
- Aveanna Home Health
- HCA Florida Healthcare at Home
- Empath Tidewell Hospice
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160822001896 | FL | Practitioner - Nurse Practitioner | 7315232923 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ARNP 2854132 | FL | MD | Adult Health Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | ARNP 2854132 | FL | |
| Gerontology Nurse Practitioner | 363LG0600X | ARNP 2854132 | FL | Yes |
Addresses
Primary practice location
209 82ND Street
Holmes Beach, FL 34217
Mailing address
PO Box 14669
Bradenton, FL 34280-4669
Phone (941) 999-2560
Other providers in Holmes Beach, FL
- Tiffany J Jamison
- Kathleen a. Schubel D.C., P.a.
- Lev Klempner
- Scott L Kosfeld
- Rick Lasavath
- Drashti Darshan Patel
- Paul J Barrese MD PA
- Stephen G Pelham
- Publix Super Markets, Inc.
- Reed Fitness and Physical Therapy
All providers in Holmes Beach, FL · Gerontology Nurse Practitioner in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.