Active NPI
Luis Gomez, ARNP
- Gerontology Nurse Practitioner
- Ormond Beach, FL
National Provider Identifier
1245716067
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- ARNP9203642
- Practice address
- 1522 Springleaf Dr
Ormond Beach, FL 32174-7314 - Phone
- (305) 240-5901
- NPI assigned
- Jul 15, 2018
- Last updated
- Jul 15, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | ARNP9203642 | FL | Primary |
Addresses
Primary practice location
1522 Springleaf Dr
Ormond Beach, FL 32174-7314
Mailing address
1522 Springleaf Dr
Ormond Beach, FL 32174-7314
Phone (305) 240-5901
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
- Opted out of Medicare
- Yes, effective Jul 1, 2025 through Jul 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ARNP9203642 | FL | MD | Gerontology Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531612800000",
"number": "1245716067",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1522 SPRINGLEAF DR",
"city": "ORMOND BEACH",
"state": "FL",
"postal_code": "321747314",
"telephone_number": "305-240-5901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1522 SPRINGLEAF DR",
"city": "ORMOND BEACH",
"state": "FL",
"postal_code": "321747314",
"telephone_number": "305-240-5901"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMEZ",
"first_name": "LUIS",
"credential": "ARNP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-07-15",
"last_updated": "2018-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "FL",
"license": "ARNP9203642",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ormond Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.