Individual provider Active NPI

Marie Isme

  • Family Nurse Practitioner
  • Fort Lauderdale, FL
National Provider Identifier
1184975070
Registry record updated May 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11006046 Issued in FL
Practice address
230 NW 53Rd St
Fort Lauderdale, FL 33309-3243
Phone
(954) 245-2399
NPI assigned
Oct 2, 2012
Last updated
May 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2023

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 11006046 FL Primary

Addresses

Primary practice location

230 NW 53Rd St
Fort Lauderdale, FL 33309-3243

Mailing address

230 NW 53Rd S
Fort Lauderdale, FL 33309-2206
Phone (954) 245-2399

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
I20230525003362 FL Practitioner - Nurse Practitioner 2062878556

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11006046FLMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1349136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684454400000",
    "number": "1184975070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 NW 53RD S",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333092206",
            "telephone_number": "954-245-2399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 NW 53RD ST",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333093243",
            "telephone_number": "954-245-2399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISME",
        "first_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-02",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11006046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.