Individual provider Active NPI

Annie Emmick, M.D.

  • Pediatrics Physician
  • Naples, FL
National Provider Identifier
1154328045
Registry record updated Nov 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME163962 Issued in FL
Practice address
11181 Health Park Blvd Ste 1000
Naples, FL 34110-5734
Phone
(239) 624-0570
Fax
(239) 624-0571
NPI assigned
Jul 7, 2005
Last updated
Nov 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME163962 FL Primary
Pediatrics Physician 208000000X 036094762 IL

Addresses

Primary practice location

11181 Health Park Blvd Ste 1000
Naples, FL 34110-5734

Mailing address

11181 Health Park Blvd Ste 1000
Naples, FL 34110-5734
Phone (239) 624-0570

Other identifiers 2

IdentifierTypeStateIssuer
2E85EOtherFLFL BCBS
119691900MedicaidFL

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230930000684 FL Practitioner - Pediatric Medicine 4688857204 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036094762ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nchmd, Inc CurrentSince Sep 20, 2023 Accepting new patients
Nchmd Inc CurrentSince Sep 20, 2023 Accepting new patients

Locations

11181 Health Park Blvd
Ste 1000
Naples, FL 34110
Phone (239) 514-3131

680 2nd Ave N
Ste 304
Naples, FL 34102
Phone (239) 261-7711

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700524800000",
    "number": "1154328045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11181 HEALTH PARK BLVD STE 1000",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341105734",
            "telephone_number": "239-624-0570",
            "fax_number": "239-624-0571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11181 HEALTH PARK BLVD STE 1000",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341105734",
            "telephone_number": "239-624-0570",
            "fax_number": "239-624-0571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMMICK",
        "first_name": "ANNIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-07",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME163962",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036094762",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL BCBS",
            "identifier": "2E85E",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119691900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

Verify at the official NPI Registry.