Individual provider Active NPI

Medlyne Revert Parrish, APRN

  • Family Nurse Practitioner
  • St Petersburg, FL
National Provider Identifier
1295698561
Registry record updated Sep 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11041922 Issued in FL
Practice address
4040 49TH St N
Saint Petersburg, FL 33709-5734
Phone
(954) 872-0270
Fax
(954) 374-6320
NPI assigned
Dec 4, 2025
Last updated
Sep 25, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2026

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 11041922 FL Primary

Addresses

Primary practice location

4040 49TH St N
Saint Petersburg, FL 33709-5734

Mailing address

4040 49TH St N
Saint Petersburg, FL 33709-5734
Phone (954) 397-3251

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11041922FLMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1764806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790294400000",
    "number": "1295698561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4040 49TH ST N",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337095734",
            "telephone_number": "954-397-3251",
            "fax_number": "954-374-6320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 49TH ST N",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337095734",
            "telephone_number": "954-872-0270",
            "fax_number": "954-374-6320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARRISH",
        "first_name": "MEDLYNE",
        "middle_name": "REVERT",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-04",
        "last_updated": "2026-09-25",
        "certification_date": "2026-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11041922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.