Individual provider Active NPI

Nellie J Baez, FNP-C

  • Family Nurse Practitioner
  • Ocoee, FL
National Provider Identifier
1174182273
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11002680 Issued in FL
Practice address
10125 W Colonial Dr Ste 205
Ocoee, FL 34761-4200
Phone
(407) 578-1241
Fax
(407) 578-1242
NPI assigned
Jun 12, 2019
Last updated
Apr 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11002680 FL Primary
Nurse Practitioner 363L00000X APRN11002680 FL

Addresses

Primary practice location

10125 W Colonial Dr Ste 205
Ocoee, FL 34761-4200

Mailing address

10125 W Colonial Dr Ste 205
Ocoee, FL 34761-4200
Phone (407) 578-1241

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
I20190711003333 FL Practitioner - Nurse Practitioner 1254666399

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11002680FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Soma Medical Center, P. a #4 Past Accepting new patients
Soma Medical Center, P. a #4 Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AWCHU1

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": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1174182273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10125 W COLONIAL DR STE 205",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347614200",
            "telephone_number": "407-578-1241",
            "fax_number": "407-578-1242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10125 W COLONIAL DR STE 205",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347614200",
            "telephone_number": "407-578-1241",
            "fax_number": "407-578-1242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAEZ",
        "first_name": "NELLIE",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-12",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11002680",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11002680",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocoee, FL

Sources for this page

Verify at the official NPI Registry.