Individual provider Active NPI

Taylor Leigh Vanderark, ARNP

  • Nurse Practitioner
  • Fort Pierce, FL
National Provider Identifier
1174098933
Registry record updated Feb 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN9385366 Issued in FL
Practice address
2100 Nebraska Ave Ste 201
Fort Pierce, FL 34950-4832
Phone
(772) 465-8100
Fax
(772) 465-8689
NPI assigned
Oct 9, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 9385366 FL
Nurse Practitioner 363L00000X APRN9385366 FL Primary

Addresses

Primary practice location

2100 Nebraska Ave Ste 201
Fort Pierce, FL 34950-4832

Mailing address

2100 Nebraska Ave Ste 201
Fort Pierce, FL 34950-4832
Phone (772) 465-8100

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
I20190605000117 FL Practitioner - Nurse Practitioner 4880927995 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Miami, LM Miller School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lawnwood Cardiovascular Surgery LLCGroup PAC ID 7214937598, 53 clinicians

Practice addresses (Care Compare)

2100 Nebraska Ave
Suite 201
Fort Pierce, FL 34950-4832
Phone (772) 465-8100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN9385366FLMDNurse Practitioner
9385366FLMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lawnwood Cardiovascular Surgery LLC CurrentSince Jan 9, 2023 Accepting new patients
Thoracic & Cardiovascular Surgeons LLC Past Accepting new patients
Coastal Care Corporation Past Accepting new patients

Locations

5301 S Congress Ave
Bldg 300
Atlantis, FL 33462
Phone (561) 548-4900

2100 Nebraska Ave
Ste 201
Fort Pierce, FL 34950
Phone (772) 461-1191

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: taylor.vanderark@hca4.eclinicaldirectplus.com

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1539043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675728000000",
    "number": "1174098933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 NEBRASKA AVE STE 201",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349504832",
            "telephone_number": "772-465-8100",
            "fax_number": "772-465-8689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 NEBRASKA AVE STE 201",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349504832",
            "telephone_number": "772-465-8100",
            "fax_number": "772-465-8689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERARK",
        "first_name": "TAYLOR",
        "middle_name": "LEIGH",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-09",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "9385366",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN9385366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

Verify at the official NPI Registry.