Individual provider Active NPI

Dasrine K Gordon, APRN

  • Family Nurse Practitioner
  • Deltona, FL
National Provider Identifier
1295235943
Registry record updated Sep 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9344126 Issued in FL
Practice address
1565 Saxon Blvd Ste 102
Deltona, FL 32725-5823
Phone
(386) 917-7395
Fax
(386) 532-7152
NPI assigned
Feb 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 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 ARNP9344126 FL Primary

Addresses

Primary practice location

1565 Saxon Blvd Ste 102
Deltona, FL 32725-5823

Mailing address

705 Cheltenham Ave
Deltona, FL 32738-9007

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
I20180503000325 FL Practitioner - Nurse Practitioner 2860756699 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Adventhealth Primary Care Network IncGroup PAC ID 1557722410, 428 clinicians

Practice addresses (Care Compare)

661 E Altamonte Dr
Suite 115
Altamonte Springs, FL 32701-5102
Phone (407) 831-4040

999 S Volusia Ave
Orange City, FL 32763-6564
Phone (386) 917-7681

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9344126FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Volusia Healthcare Corporation CurrentSince Jun 7, 2024 Accepting new patients
Adventhealth Primary Care Network Inc Family CurrentSince Aug 1, 2023 Accepting new patients

Locations

661 E Altamonte Dr
Ste 115
Altamonte Springs, FL 32701
Phone (407) 831-4040

190 N Charles Richard Beall Blvd
Ste 103
Debary, FL 32713
Phone (386) 917-7670

1565 Saxon Blvd
Ste 102
Deltona, FL 32725
Phone (386) 789-5400

1061 Medical Center Dr
Orange City, FL 32763
Phone (386) 917-5000

1035 Town Center Dr
Orange City, FL 32763
Phone (386) 775-8229

Interoperability endpoints

  • Direct secure messaging: dgordon72913@adventhealth.direct-ci.com

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 7

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": "1519084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569456000000",
    "number": "1295235943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 CHELTENHAM AVE",
            "city": "DELTONA",
            "state": "FL",
            "postal_code": "327389007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1565 SAXON BLVD STE 102",
            "city": "DELTONA",
            "state": "FL",
            "postal_code": "327255823",
            "telephone_number": "386-917-7395",
            "fax_number": "386-532-7152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "DASRINE",
        "middle_name": "K",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-20",
        "last_updated": "2019-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9344126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deltona, FL

Sources for this page

Verify at the official NPI Registry.