Individual provider Active NPI

Sheryl Diane Fagan, A.R.N.P.

  • Adult Health Nurse Practitioner
  • Lutz, FL
National Provider Identifier
1295055242
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
ARNP1662752 Issued in FL
Practice address
4211 Van Dyke Rd
Suite 200
Lutz, FL 33558-8005
Phone
(813) 264-6490
Fax
(813) 443-8143
NPI assigned
Jun 1, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2026

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 ARNP1662752 FL Primary

Addresses

Primary practice location

4211 Van Dyke Rd
Suite 200
Lutz, FL 33558-8005

Mailing address

2995 Drew St FL 2
Clearwater, FL 33759-3012
Phone (727) 532-0002

Other identifiers 1

IdentifierTypeStateIssuer
002400000MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Sheryl.FaganAPRN@direct.mybaycare.org

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
I20100914000205 FL Practitioner - Nurse Practitioner 7810012945 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baycare Medical Group, Inc.Group PAC ID 6406753623, 1,539 clinicians

Practice addresses (Care Compare)

4730 N Habana Ave
Suite 300
Tampa, FL 33614-7148
Phone (813) 876-0951

Hospital & facility affiliations

  • St Josephs Hospital Hospital, Tampa, FL, CCN 100075

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Medical Group, Inc. CurrentSince May 1, 2015 Accepting new patients
Baycare Medical Group, Inc. CurrentSince May 1, 2015 Accepting new patients

Locations

2995 Drew St
Fl 2
Clearwater, FL 33759
Phone (727) 315-7234

2461 Enterprise Rd
Ste C
Clearwater, FL 33763
Phone (727) 725-5060

4211 Van Dyke Rd
#200
Lutz, FL 33558
Phone (813) 264-6490

4211 Van Dyke Rd
Ste 200
Lutz, FL 33558
Phone (813) 264-6490

4730 N Habana Ave
Ste 300
Tampa, FL 33614
Phone (813) 352-9465

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1275350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787875200000",
    "number": "1295055242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2995 DREW ST FL 2",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337593012",
            "telephone_number": "727-532-0002",
            "fax_number": "813-635-2613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4211 VAN DYKE RD",
            "address_2": "SUITE 200",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335588005",
            "telephone_number": "813-264-6490",
            "fax_number": "813-443-8143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGAN",
        "first_name": "SHERYL",
        "middle_name": "DIANE",
        "name_prefix": "Ms.",
        "credential": "A.R.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-01",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP1662752",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002400000",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Sheryl.FaganAPRN@direct.mybaycare.org",
            "affiliation": "N",
            "address_1": "4211 Van Dyke Rd",
            "address_2": "Suite 200",
            "city": "Lutz",
            "state": "FL",
            "country_code": "US",
            "postal_code": "335588005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lutz, FL

Sources for this page

Verify at the official NPI Registry.