Individual provider Active NPI

Alicia Self, DNP-FNP-C

  • Family Nurse Practitioner
  • Lakeland, FL
National Provider Identifier
1154885804
Registry record updated May 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11002709 Issued in FL
Practice address
211 E Main St # 435
Lakeland, FL 33801-4628
Phone
(863) 595-6909
NPI assigned
Jan 28, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 25, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X C-APN.0102110-C-NP CO
Nurse Practitioner 363L00000X 308247 AZ
Registered Nurse 163W00000X RN9655562 FL
Family Nurse Practitioner 363LF0000X APRN11002709 FL Primary

Addresses

Primary practice location

211 E Main St # 435
Lakeland, FL 33801-4628

Mailing address

PO Box 971
Kathleen, FL 33849-0971
Phone (863) 944-6977

Other practice location 1

1501 Biscayne Blvd
Miami, FL 33132-1449
Phone (877) 870-0323

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
I20200624001934 FL Practitioner - Nurse Practitioner 1153743927 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN9655562FLMDRegistered Nurse
308247AZMDNurse Practitioner
C-APN.0102110-C-NPCOMDNurse Practitioner
APRN11002709FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Opulent Medical Care LLC CurrentSince Mar 30, 2025 Accepting new patients
Openloop Healthcare Partners PC Nurse Practitioner CurrentSince Sep 6, 2025 Accepting new patients
Angel Eyes Home Care LLC CurrentSince Mar 30, 2025 Accepting new patients
Ig Health and Wellness Past Accepting new patients
Openloop Healthcare Partners New Jersey PC Nurse Practitioner Past Accepting new patients

Locations

3707 E Southern Ave
#1
Mesa, AZ 85206
Phone (424) 387-6806

3707 E Southern Ave
#2
Mesa, AZ 85206

211 E Main St
#435
Lakeland, FL 33801
Phone (863) 595-6909

1500 Lakeland Hills Blvd
Ste 2
Lakeland, FL 33805
Phone (863) 682-8200

8270 Woodland Center Blvd
Tampa, FL 33614
Phone (305) 449-9219

317 6th Ave
Ste 400
Des Moines, IA 50309
Phone (515) 612-9097

1 Westbrook Corporate Ctr
Westchester, IL 60154
Phone (708) 256-7231

Organizations & group practices 5

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": "1548633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779667200000",
    "number": "1154885804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 971",
            "city": "KATHLEEN",
            "state": "FL",
            "postal_code": "338490971",
            "telephone_number": "863-944-6977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 E MAIN ST # 435",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338014628",
            "telephone_number": "863-595-6909"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501 Biscayne Blvd",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331321449",
            "country_code": "US",
            "telephone_number": "877-870-0323",
            "fax_number": "866-427-3798",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SELF",
        "first_name": "ALICIA",
        "name_prefix": "Dr.",
        "credential": "DNP-FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-28",
        "last_updated": "2026-05-25",
        "certification_date": "2026-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "C-APN.0102110-C-NP",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "308247",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9655562",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11002709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.