Individual provider Active NPI

Ehiliana Isabel Conde, NP

  • Family Nurse Practitioner
  • Naples, FL
National Provider Identifier
1154911212
Registry record updated Apr 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11010449 Issued in FL
Practice address
311 9TH St N
Naples, FL 34102-5885
Phone
(239) 624-8020
Fax
(239) 624-8021
NPI assigned
Jan 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11010449 FL Primary

Addresses

Primary practice location

311 9TH St N
Naples, FL 34102-5885

Mailing address

PO Box 26067
Salt Lake City, UT 84126-0067
Phone (239) 624-0400

Other practice location 1

10201 Arcos Ave Ste 207
Estero, FL 33928-9461
Phone (239) 301-0968

Other identifiers 2

IdentifierTypeStateIssuer
109723100MedicaidFL
1JYQIOtherFLBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11010449FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf Coast Medical Associates LLC PastSince May 11, 2024 Accepting new patients
Usrc Southeast Sarasota LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: econde22762@nchhealthcaresystem.direct-ci.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1611273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618876800000",
    "number": "1154911212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26067",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841260067",
            "telephone_number": "239-624-0400",
            "fax_number": "239-624-0401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 9TH ST N",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341025885",
            "telephone_number": "239-624-8020",
            "fax_number": "239-624-8021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10201 Arcos Ave Ste 207",
            "address_purpose": "LOCATION",
            "city": "Estero",
            "state": "FL",
            "postal_code": "339289461",
            "country_code": "US",
            "telephone_number": "239-301-0968",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONDE",
        "first_name": "EHILIANA",
        "middle_name": "ISABEL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-22",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11010449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109723100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1JYQI",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

Verify at the official NPI Registry.