Organization Active NPI

Linda R. Fagan Inc.

  • Family Nurse Practitioner
  • Homestead, FL
National Provider Identifier
1245582824
Registry record updated Oct 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP647292 Issued in FL
Legal business name
LINDA R. FAGAN INC.
Practice address
45 NW 4TH St
Homestead, FL 33030-5941
Phone
(305) 246-8224
Fax
(305) 246-8556
NPI assigned
Oct 8, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2012

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

Authorized official

Name
Ms. Linda R Fagan, ARNP
Title
President
Phone
(305) 246-8224

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X ARNP647292 FL Primary

Addresses

Primary practice location

45 NW 4TH St
Homestead, FL 33030-5941

Mailing address

45 NW 4TH St
Homestead, FL 33030-5941
Phone (305) 246-8224

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121219000383 FL Part B Supplier - Clinic/Group Practice 3971755976 Receives reassigned benefits from 1 practitioner
Practice locations: Homestead, FL

National Provider Directory

National Provider Directory
Tax ID family
Linda R Fagan Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1349654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349654400000",
    "number": "1245582824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 NW 4TH ST",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330305941",
            "telephone_number": "305-246-8224",
            "fax_number": "305-246-8556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 NW 4TH ST",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330305941",
            "telephone_number": "305-246-8224",
            "fax_number": "305-246-8556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINDA R. FAGAN INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-08",
        "last_updated": "2012-10-08",
        "status": "A",
        "authorized_official_last_name": "FAGAN",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-246-8224",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP647292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homestead, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.