Individual provider Active NPI

Rosario Correa, ARNP

  • Pediatric Nurse Practitioner
  • Port St Lucie, FL
National Provider Identifier
1215906557
Registry record updated Nov 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
APRN9200331 Issued in FL
Practice address
466 SW Port St Lucie Blvd Ste 116
Port St Lucie, FL 34953-2091
Phone
(772) 237-4518
Fax
(772) 461-9972
NPI assigned
Mar 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X APRN9200331 FL Primary

Addresses

Primary practice location

466 SW Port St Lucie Blvd Ste 116
Port St Lucie, FL 34953-2091

Mailing address

466 SW Port St Lucie Blvd Ste 116
Port St Lucie, FL 34953-2091
Phone (772) 237-4518

Other identifiers 1

IdentifierTypeStateIssuer
307735700MedicaidFL

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN9200331FLMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Rosie'S Pediatrics CurrentSince Dec 26, 2021 Accepting new patients

Locations

466 SW Port St Lucie Blvd
Ste 116
Port St Lucie, FL 34953
Phone (772) 237-4518

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1215906557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "466 SW PORT ST LUCIE BLVD STE 116",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349532091",
            "telephone_number": "772-237-4518",
            "fax_number": "772-237-4622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "466 SW PORT ST LUCIE BLVD STE 116",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349532091",
            "telephone_number": "772-237-4518",
            "fax_number": "772-461-9972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORREA",
        "first_name": "ROSARIO",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-17",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "APRN9200331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "307735700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.