Individual provider Active NPI

Heidi Sue Reves, FNP

  • Family Nurse Practitioner
  • Bartow, FL
National Provider Identifier
1235843095
Registry record updated Jan 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN9263154 Issued in FL
Practice address
1255 Golfview Ave
Bartow, FL 33830-6736
Phone
(863) 519-5174
NPI assigned
Jan 6, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2023

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 APRN9263154 FL Primary

Addresses

Primary practice location

1255 Golfview Ave
Bartow, FL 33830-6736

Mailing address

1519 Cordgrass Way
Lakeland, FL 33813-2715
Phone (863) 512-4836

Other practice location 1

715 N Lake Ave
Lakeland, FL 33801-1908
Phone (863) 519-0575

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

State licenses

LicenseStateTypeSpecialty
APRN9263154FLMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1672963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672963200000",
    "number": "1235843095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1519 CORDGRASS WAY",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132715",
            "telephone_number": "863-512-4836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 GOLFVIEW AVE",
            "city": "BARTOW",
            "state": "FL",
            "postal_code": "338306736",
            "telephone_number": "863-519-5174"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "715 N Lake Ave",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338011908",
            "country_code": "US",
            "telephone_number": "863-519-0575",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REVES",
        "first_name": "HEIDI",
        "middle_name": "SUE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-06",
        "last_updated": "2023-01-06",
        "certification_date": "2023-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9263154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bartow, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2023; 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.