Individual provider Active NPI

Gabrielle Alexis Lisbon

  • Family Nurse Practitioner
  • Winter Garden, FL
National Provider Identifier
1215767660
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11034463 Issued in FL
Practice address
301 S West Crown Point Rd Ste 120
Winter Garden, FL 34787-2916
Phone
(407) 297-8408
NPI assigned
Aug 1, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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 11034463 FL Primary

Addresses

Primary practice location

301 S West Crown Point Rd Ste 120
Winter Garden, FL 34787-2916

Mailing address

301 S West Crown Point Rd Ste 120
Winter Garden, FL 34787-2916
Phone (407) 297-8408

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
I20250124002040 FL Practitioner - Nurse Practitioner 6901335694 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
West Orange Nephrology LLCGroup PAC ID 8325016397, 5 clinicians

Practice addresses (Care Compare)

301 S W Crown Point Rd
Suite 120
Winter Garden, FL 34787-2950
Phone (407) 297-8408

Hospital & facility affiliations

  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007
  • Orlando Health-Health Central Hospital Hospital, Ocoee, FL, CCN 100030
  • Orlando Health Hospital, Orlando, FL, CCN 100006

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11034463FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
West Orange Nephrology LLC CurrentSince Jan 1, 2025 Accepting new patients
Onyx Medical & Wellness Center LLC PastSince Jan 1, 2025 Accepting new patients

Locations

10000 W Colonial Dr
Ste 180
Ocoee, FL 34761
Phone (407) 578-6610

301 S West Crown Point Rd
Ste 120
Winter Garden, FL 34787

Interoperability endpoints

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

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 5

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": "1722470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1215767660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 S WEST CROWN POINT RD STE 120",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347872916",
            "telephone_number": "407-297-8408",
            "fax_number": "407-297-8409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S WEST CROWN POINT RD STE 120",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347872916",
            "telephone_number": "407-297-8408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISBON",
        "first_name": "GABRIELLE",
        "middle_name": "ALEXIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-01",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11034463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Garden, FL

Sources for this page

Verify at the official NPI Registry.