Individual provider Active NPI

Neika Nicole Small, APRN

  • Adult Health Nurse Practitioner
  • Port St Lucie, FL
National Provider Identifier
1255097655
Registry record updated Jun 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
11016330 Issued in FL
Practice address
11087 SW Ivory Springs LN
Port St Lucie, FL 34987-7711
Phone
(954) 854-8838
NPI assigned
Nov 10, 2021
Last updated
Jun 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 11016330 FL Primary

Addresses

Primary practice location

11087 SW Ivory Springs LN
Port St Lucie, FL 34987-7711

Mailing address

11087 SW Ivory Springs LN
Port St Lucie, FL 34987-7711
Phone (954) 854-8838

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
I20230410002608 FL Practitioner - Nurse Practitioner 4587039326 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10000 SW Innovation Way
Port Saint Lucie, FL 34987-2111
Phone (772) 345-8100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11016330FLMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Martin Memorial Medical Center Inc CurrentSince Jan 1, 2025 Accepting new patients
Advanced Cardiovascular Consultants LLC CurrentSince Mar 12, 2023 Accepting new patients

Locations

10000 SW Innovation Way
Port St Lucie, FL 34987
Phone (772) 288-5853

200 SE Hospital Ave
Stuart, FL 34994
Phone (772) 223-5618

5305 Greenwood Ave
Ste 204
West Palm Beach, FL 33407
Phone (561) 832-8886

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18542/brand/1/csg/1/fhir/r4
  • Direct secure messaging: nsmithsmall20897@jupitermedicalcenter.direct-ci.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1636502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686268800000",
    "number": "1255097655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11087 SW IVORY SPRINGS LN",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349877711",
            "telephone_number": "954-854-8838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11087 SW IVORY SPRINGS LN",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349877711",
            "telephone_number": "954-854-8838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALL",
        "first_name": "NEIKA",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-10",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "11016330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.