Individual provider Active NPI

Amanda Nichole Wouk, APRN

  • Family Nurse Practitioner
  • Fort Myers, FL
National Provider Identifier
1295136265
Registry record updated Jun 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP3072212 Issued in FL
Practice address
4751 S Cleveland Ave
Fort Myers, FL 33907
Phone
(239) 343-9888
Fax
(239) 343-9868
NPI assigned
Sep 10, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP3072212 FL
Family Nurse Practitioner 363LF0000X ARNP3072212 FL Primary

Addresses

Primary practice location

4751 S Cleveland Ave
Fort Myers, FL 33907

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-9888

Other identifiers 1

IdentifierTypeStateIssuer
013226500MedicaidFL

Other names 1

  • Amanda Nichole Ranft 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
I20141023001171 FL Practitioner - Nurse Practitioner 2567683121 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Health System Inc CurrentSince Oct 1, 2024 Accepting new patients
Lee Memorial Health System CurrentSince Jan 2, 2023 Accepting new patients
Lee Health System Inc Nurse Practitioner CurrentSince Oct 1, 2024 Accepting new patients

Locations

1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900

650 Del Prado Blvd S
Ste 107
Cape Coral, FL 33990

23450 Via Coconut Pt
Estero, FL 34135
Phone (239) 468-0150

8931 Colonial Center Dr
Ste 401
Fort Myers, FL 33905
Phone (239) 424-2030

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

4751 S Cleveland Ave
Fort Myers, FL 33907
Phone (239) 343-9880

930 S Main St
Ste C
Labelle, FL 33935
Phone (239) 674-5520

260 Beth Stacey Blvd
Ste C
Lehigh Acres, FL 33936

Interoperability endpoints

  • Direct secure messaging: aranft86968@direct.leememorial.org

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": "1410307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592438400000",
    "number": "1295136265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-343-9888",
            "fax_number": "239-343-9868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4751 S CLEVELAND AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "33907",
            "telephone_number": "239-343-9888",
            "fax_number": "239-343-9868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOUK",
        "first_name": "AMANDA",
        "middle_name": "NICHOLE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-10",
        "last_updated": "2020-06-18",
        "certification_date": "2020-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP3072212",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP3072212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "013226500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "RANFT",
            "middle_name": "NICHOLE",
            "credential": "ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.