Individual provider Active NPI

Andrea Montoya

  • Family Nurse Practitioner
  • Wellington, FL
National Provider Identifier
1194414151
Registry record updated May 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11026108 Issued in FL
Practice address
12161 Ken Adams Way Ste 110-Y
Wellington, FL 33414-3194
Phone
(561) 270-6624
NPI assigned
May 4, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 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 11026108 FL Primary

Addresses

Primary practice location

12161 Ken Adams Way Ste 110-Y
Wellington, FL 33414-3194

Mailing address

12161 Ken Adams Way Ste 110-Y
Wellington, FL 33414-3194
Phone (561) 270-6624

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11026108FLMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1683158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1194414151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12161 KEN ADAMS WAY STE 110-Y",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334143194",
            "telephone_number": "561-270-6624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12161 KEN ADAMS WAY STE 110-Y",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334143194",
            "telephone_number": "561-270-6624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTOYA",
        "first_name": "ANDREA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-04",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11026108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.