Gina M Hedstrom, RN

Primary specialty

General Practice Registered NurseTaxonomy code 163WG0000X

License

RN9179912 Issued in FL

Practice address

939 Lalonde Rd
North Fort Myers, FL 33917-3230

Phone

(414) 336-9565

NPI assigned

Dec 27, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1672099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672099200000",
    "number": "1194438846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "939 LALONDE RD",
            "city": "NORTH FORT MYERS",
            "state": "FL",
            "postal_code": "339173230",
            "telephone_number": "414-336-9565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "939 LALONDE RD",
            "city": "NORTH FORT MYERS",
            "state": "FL",
            "postal_code": "339173230",
            "telephone_number": "414-336-9565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEDSTROM",
        "first_name": "GINA",
        "middle_name": "M",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-27",
        "last_updated": "2022-12-27",
        "certification_date": "2022-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "WI",
            "license": "33027",
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, General Practice",
            "state": "FL",
            "license": "RN9179912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "103417",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gina@oriontcs.com",
            "affiliation": "N",
            "endpointDescription": "TEAMS",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "939 Lalonde Rd",
            "city": "North Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339173230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• General Practice Registered Nurse in North Fort Myers, FL
• Providers in North Fort Myers, FL by specialty
• General Practice Registered Nurse in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2022; 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.