Individual provider Active NPI

Sheila Diaz

  • Family Nurse Practitioner
  • Indian Harbour Beach, FL
National Provider Identifier
1255990883
Registry record updated Jun 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11002010 Issued in FL
Practice address
2040 Highway A1A Ste 209
Indian Harbour Beach, FL 32937-3566
Phone
(321) 425-2233
NPI assigned
Jun 7, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2019

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 11002010 FL Primary

Addresses

Primary practice location

2040 Highway A1A Ste 209
Indian Harbour Beach, FL 32937-3566

Mailing address

2040 Highway A1A Ste 209
Indian Harbour Beach, FL 32937-3566
Phone (321) 425-2233

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11002010FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
JMJ Family Practice Inc CurrentSince Aug 24, 2019 Accepting new patients

Locations

2040 Highway A1A
Ste 209
Indian Harbour Beach, FL 32937
Phone (321) 425-2233

300 N John Young Pkwy
Kissimmee, FL 34741
Phone (407) 935-9012

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10787/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1559865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559865600000",
    "number": "1255990883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 HIGHWAY A1A STE 209",
            "city": "INDIAN HARBOUR BEACH",
            "state": "FL",
            "postal_code": "329373566",
            "telephone_number": "321-425-2233",
            "fax_number": "321-421-7213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 HIGHWAY A1A STE 209",
            "city": "INDIAN HARBOUR BEACH",
            "state": "FL",
            "postal_code": "329373566",
            "telephone_number": "321-425-2233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "SHEILA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-07",
        "last_updated": "2019-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11002010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indian Harbour Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2019; 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.