Active NPI
Agata Nelson, LM
- Obstetrics Physician
- Fernandina Beach, FL
National Provider Identifier
1144619594
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics Physician
- License
- 305
- Practice address
- 910 S 8TH St
Suite 100
Fernandina Beach, FL 32034-3744 - Phone
- (904) 875-4278
- Fax
- (904) 572-1571
- NPI assigned
- Jan 22, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics Physician | 207VX0000X | 305 | FL | Primary |
Addresses
Primary practice location
910 S 8TH St
Suite 100
Fernandina Beach, FL 32034-3744
Mailing address
910 S 8TH St
Suite 100
Fernandina Beach, FL 32034-3744
Phone (904) 875-4278
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 305 | FL | MD | Obstetrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bundle of Joy Birth & Wellness Center | Past | Accepting new patients |
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.
-
- Birthing Clinic/Center
- Fernandina Beach, FL
- NPI 1093113342
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1421884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1421884800000",
"number": "1144619594",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "910 S 8TH ST",
"address_2": "SUITE 100",
"city": "FERNANDINA BEACH",
"state": "FL",
"postal_code": "320343744",
"telephone_number": "904-875-4278",
"fax_number": "904-572-1571"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "910 S 8TH ST",
"address_2": "SUITE 100",
"city": "FERNANDINA BEACH",
"state": "FL",
"postal_code": "320343744",
"telephone_number": "904-875-4278",
"fax_number": "904-572-1571"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "AGATA",
"name_prefix": "Mrs.",
"credential": "LM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-01-22",
"last_updated": "2015-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "207VX0000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Obstetrics",
"state": "FL",
"license": "305",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fernandina Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.