Dwayne Dunkerson
Individual provider Active NPI Family Nurse Practitioner · Parrish, FL
NPI 1235667205 · NPPES record last updated Mar 9, 2022
Key facts
- NPI
- 1235667205
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- APRN11006893 (FL)
- Practice address
- 16314 Rivers Reach Blvd
Parrish, FL 34219-2782 - Phone
- (423) 444-5896
- NPI assigned
- Jun 2, 2017
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201008002082 | FL | Practitioner - Nurse Practitioner | 5799056453 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| WT Health of Florida LLC | Current |
Accepting new patients | |
| Wound Technology Network | Past | Accepting new patients |
Locations
200 S Park Rd
Ste 200
Hollywood, FL 33021
Phone (866) 986-2263
5979 Vineland Rd
Ste 109
Orlando, FL 32819
Phone (407) 270-7702
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 0024174887 | VA | |
| Family Nurse Practitioner | 363LF0000X | APRN11006893 | FL | Yes |
Addresses
Primary practice location
16314 Rivers Reach Blvd
Parrish, FL 34219-2782
Mailing address
16314 Rivers Reach Blvd
Parrish, FL 34219-2782
Phone (423) 444-5896
Other providers in Parrish, FL
- Jeannene L Dieter
- Ludmilla Dieujuste
- Angelo Sebastian Domingo
- Melissa Beth Dressler
- Cassie Duffy
- Nelson Hernando Duran
- Nickolas A Dwyer
- Jessica Eastman
- Ethan Frederick Effinger
- Ellenton Discount Pharmacy LLC
All providers in Parrish, FL · Family Nurse Practitioner in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 9, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.