Individual provider Active NPI

Tina Gail Gaskin, ARNP

  • Family Nurse Practitioner
  • Daytona Beach, FL
National Provider Identifier
1235463266
Registry record updated Mar 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9211084 Issued in FL
Practice address
1410 Lpga Blvd
Ste. 136
Daytona Beach, FL 32117-5115
Phone
(386) 274-4750
Fax
(386) 274-2499
NPI assigned
Sep 23, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2014

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 ARNP9211084 FL Primary

Addresses

Primary practice location

1410 Lpga Blvd
Ste. 136
Daytona Beach, FL 32117-5115

Mailing address

1410 Lpga Blvd
Ste. 136
Daytona Beach, FL 32117-5115
Phone (386) 274-4750

Other identifiers 1

IdentifierTypeStateIssuer
0015594400MedicaidFL

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
I20091112000636 FL Practitioner - Nurse Practitioner 5395883243 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Century Clinical Family Medicine Current Accepting new patients
Gold Diagnostics Corp CurrentSince Feb 20, 2023 Accepting new patients
Century Clinical Family Medicine, LLC. Family CurrentSince Jan 3, 2011 Accepting new patients
SHC Medical Partners of Florida, LLC CurrentSince Feb 5, 2021 Accepting new patients

Locations

1410 Lpga Blvd
Ste 140
Daytona Beach, FL 32117
Phone (386) 274-4750

1410 Lpga Blvd
Ste 136
Daytona Beach, FL 32117
Phone (386) 274-4750

3440 Hollywood Blvd
Ste 415
Hollywood, FL 33021
Phone (281) 912-3264

103 Clyde Morris Blvd
Ormond Beach, FL 32174
Phone (386) 673-0450

4033 Beaver Ln
Pt Charlotte, FL 33952
Phone (941) 212-2748

805 N Whittington Pkwy
Ste 400
Louisville, KY 40222
Phone (502) 272-3438

12201 Bluegrass Pkwy
Louisville, KY 40299
Phone (502) 568-7364

10101 Fondren Rd
Ste 112
Houston, TX 77096
Phone (281) 912-3264

Interoperability endpoints

  • Direct secure messaging: gaskin.tina.001.0050240@cecl.meditab.direct-ci.com

Organizations & group practices 4

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": "1253664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395273600000",
    "number": "1235463266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 LPGA BLVD",
            "address_2": "STE. 136",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175115",
            "telephone_number": "386-274-4750",
            "fax_number": "386-274-2499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 LPGA BLVD",
            "address_2": "STE. 136",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175115",
            "telephone_number": "386-274-4750",
            "fax_number": "386-274-2499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GASKIN",
        "first_name": "TINA",
        "middle_name": "GAIL",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-23",
        "last_updated": "2014-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9211084",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015594400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.