Individual provider Active NPI

McEba Weston Chishimba, APRN-C

  • Family Nurse Practitioner
  • Clearwater, FL
National Provider Identifier
1194201392
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN9318321 Issued in FL
Practice address
2350 Sunset Point Rd Ste C
Clearwater, FL 33765-1443
Phone
(727) 797-3155
Fax
(727) 797-4301
NPI assigned
Jul 11, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN9318321 FL
Family Nurse Practitioner 363LF0000X 9318321 FL
Family Nurse Practitioner 363LF0000X APRN9318321 FL Primary

Addresses

Primary practice location

2350 Sunset Point Rd Ste C
Clearwater, FL 33765-1443

Mailing address

2350 Sunset Point Rd Ste C
Clearwater, FL 33765-1443
Phone (727) 797-3155

Other identifiers 1

IdentifierTypeStateIssuer
101591300MedicaidFL

Other names 1

  • Mr. Weston Mgeba Chishimba Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Mceba.Chishimba@direct.mybaycare.org Health Information Exchange (HIE) BayCare Medical Group, Inc.

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
I20181015000414 FL Practitioner - Nurse Practitioner 5698027910 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baycare Medical Group, Inc.Group PAC ID 6406753623, 1,539 clinicians

Practice addresses (Care Compare)

2350 Sunset Point Rd
Suite C
Clearwater, FL 33765-1443
Phone (727) 797-3155

2461 Enterprise Rd
Suite C
Clearwater, FL 33763-1726
Phone (727) 725-5060

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9318321FLMDFamily Nurse Practitioner
APRN9318321FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Medical Group, Inc. CurrentSince Jun 1, 2019 Accepting new patients
Baycare Medical Group, Inc. Nurse Practitioner CurrentSince Jun 1, 2019 Accepting new patients

Locations

2995 Drew St
Fl 2
Clearwater, FL 33759
Phone (727) 315-7234

2461 Enterprise Rd
Ste C
Clearwater, FL 33763
Phone (727) 725-5060

2350 Sunset Point Rd
Ste C
Clearwater, FL 33765
Phone (727) 797-3155

Interoperability endpoints

  • Direct secure messaging: mceba.chishimba@direct.mybaycare.org

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.

Hospital & facility affiliations 3

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": "1531267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1194201392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 SUNSET POINT RD STE C",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337651443",
            "telephone_number": "727-797-3155",
            "fax_number": "727-797-4301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 SUNSET POINT RD STE C",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337651443",
            "telephone_number": "727-797-3155",
            "fax_number": "727-797-4301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHISHIMBA",
        "first_name": "MCEBA",
        "middle_name": "WESTON",
        "name_prefix": "Mr.",
        "credential": "APRN-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-11",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN9318321",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9318321",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9318321",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101591300",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Mceba.Chishimba@direct.mybaycare.org",
            "affiliation": "Y",
            "affiliationName": "BayCare Medical Group, Inc.",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2995 Drew St Fl 2",
            "city": "Clearwater",
            "state": "FL",
            "country_code": "US",
            "postal_code": "337593012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "WESTON",
            "last_name": "CHISHIMBA",
            "middle_name": "MGEBA",
            "prefix": "MR.",
            "credential": "APRN-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.