Individual provider Active NPI

Lora Diane Nylund, MSN, APRN

  • Nurse Practitioner
  • St Petersburg, FL
National Provider Identifier
1134917222
Registry record updated Jun 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11038011 Issued in FL
Practice address
3520 38TH Ave N
St Petersburg, FL 33713-1448
Phone
(727) 471-5039
NPI assigned
Apr 28, 2025
Sex
Unspecified or another gender identity
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 11038011 FL
Nurse Practitioner 363L00000X 11038011 FL Primary

Addresses

Primary practice location

3520 38TH Ave N
St Petersburg, FL 33713-1448

Mailing address

28744 Stormcloud Pass
Wesley Chapel, FL 33543-6424
Phone (901) 254-9844

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
I20250626001958 FL Practitioner - Nurse Practitioner 2264944909 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11038011FLMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bowman & Hampsey Medical Clinic, Inc CurrentSince Jun 9, 2025 Accepting new patients

Locations

3251 N McMullen Booth Rd
Clearwater, FL 33761
Phone (727) 725-6110

3520 38th Ave N
St Petersburg, FL 33713
Phone (727) 471-5039

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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": "1745798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749772800000",
    "number": "1134917222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28744 STORMCLOUD PASS",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335436424",
            "telephone_number": "901-254-9844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3520 38TH AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337131448",
            "telephone_number": "727-471-5039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYLUND",
        "first_name": "LORA",
        "middle_name": "DIANE",
        "credential": "MSN, APRN",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2025-04-28",
        "last_updated": "2025-06-13",
        "certification_date": "2025-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "11038011",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11038011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.