Medi-Eagle Express Healthcare LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

MEDI-EAGLE EXPRESS HEALTHCARE LLC

Practice address

4202 Berry Cove Cir
Richmond, TX 77406-7216

Phone

(407) 927-2891

NPI assigned

Jun 13, 2020

Last updated

Dec 17, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Micaela N Gordon

Title

FNP

Phone

(407) 927-2891

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

{
    "created_epoch": "1592006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608163200000",
    "number": "1275158420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4202 BERRY COVE CIR",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774067216",
            "telephone_number": "407-927-2891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4202 BERRY COVE CIR",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774067216",
            "telephone_number": "407-927-2891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDI-EAGLE EXPRESS HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-13",
        "last_updated": "2020-12-17",
        "certification_date": "2020-12-17",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "MICAELA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "FNP",
        "authorized_official_telephone_number": "407-927-2891",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER LICENSE NUMBER",
            "identifier": "AP144351",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "micaela.lunangordon@hcahealthcare.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Health Information",
            "address_1": "4202 Berry Cove Cir # 2",
            "city": "Richmond",
            "state": "TX",
            "country_code": "US",
            "postal_code": "774067216",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Family Nurse Practitioner in Richmond, TX
• Providers in Richmond, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2020; 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.