Individual provider Active NPI

Carol A Ives, ARNP

  • Adult Health Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1295074250
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
ARNP9264392 Issued in FL
Practice address
5130 Sunforest Dr Ste 300
Tampa, FL 33634-6327
Phone
(727) 824-0780
NPI assigned
Feb 11, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

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 ARNP9264392 FL Primary

Addresses

Primary practice location

5130 Sunforest Dr Ste 300
Tampa, FL 33634-6327

Mailing address

5130 Sunforest Dr Ste 300
Tampa, FL 33634-6327
Phone (727) 824-0780

Other identifiers 1

IdentifierTypeStateIssuer
009214100MedicaidFL

Other names 1

  • Carol A Luckett Former name

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
I20130820001027 FL Practitioner - Nurse Practitioner 2264675354 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optumcare Florida, LLCGroup PAC ID 3072403476, 266 clinicians

Practice addresses (Care Compare)

5130 Sunforest Dr
Suite 300
Tampa, FL 33634-6327
Phone (727) 824-0780

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Optumcare Florida, LLC CurrentSince Jul 20, 2020 Accepting new patients
Optumcare Florida LLC CurrentSince Jul 20, 2020 Accepting new patients
Wellmed Medical Management of Florida Inc CurrentSince Mar 1, 2023 Accepting new patients
Optumcare Florida Ci, LLC Past Accepting new patients

Locations

1345 West Bay Dr
Ste 202
Largo, FL 33770
Phone (727) 559-0895

7601 Dr Ml King Jr St N
Ste E
St Petersburg, FL 33702
Phone (727) 527-6719

2191 9th Ave N
St Petersburg, FL 33713
Phone (727) 820-7778

10051 5th St N
Ste 200
St Petersburg, FL 33702
Phone (727) 286-4093

2155 SE Federal Hwy
Stuart, FL 34994
Phone (772) 223-9630

5130 Sunforest Dr
Ste 300
Tampa, FL 33634
Phone (813) 302-5835

8637 Fredericksburg Rd
Ste 360
San Antonio, TX 78240
Phone (210) 304-3500

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: carol.ives@wellmed.eclinicaldirectplus.com
  • Direct secure messaging: cives@direct.meditouchehr.com

Organizations & group practices 4

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": "1360540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1295074250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5130 SUNFOREST DR STE 300",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336346327",
            "telephone_number": "727-824-0780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5130 SUNFOREST DR STE 300",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336346327",
            "telephone_number": "727-824-0780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVES",
        "first_name": "CAROL",
        "middle_name": "A",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-11",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP9264392",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009214100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROL",
            "last_name": "LUCKETT",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.