Richard Michael Nestrud, M.D.

Primary specialty

Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X

License

C4891 Issued in AR

Practice address

108 Washboard CT
Port St Joe, FL 32456-4761

Phone

(501) 225-8821

Fax

(501) 225-0917

NPI assigned

May 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582156800000",
    "number": "1306897376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 956",
            "city": "PORT ST JOE",
            "state": "FL",
            "postal_code": "324570956",
            "telephone_number": "501-247-5219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 WASHBOARD CT",
            "city": "PORT ST JOE",
            "state": "FL",
            "postal_code": "324564761",
            "telephone_number": "501-225-8821",
            "fax_number": "501-225-0917"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Mercy Hospital",
            "address_2": "7301 Rogers Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Smith",
            "state": "AR",
            "postal_code": "72903",
            "country_code": "US",
            "telephone_number": "479-314-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NESTRUD",
        "first_name": "RICHARD",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "FL",
            "license": "ME126444",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "AR",
            "license": "C4891",
            "primary": true
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "AR",
            "license": "C-4891",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "N/A",
            "affiliation": "N",
            "address_1": "108 Washboard Ct",
            "city": "Port St Joe",
            "state": "FL",
            "country_code": "US",
            "postal_code": "324564761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Joshua Mick, MPT
• Amy E. Miller, APRN
• Mary Sue Moore, PMHNP
• Ann R Morris, RN
• Jill Marlene Nance, LCSW
• New Horizon Primary Care, LLC
• David Joseph Newton, MD
• North Florida Surgeons, PA (NFS Northwest Florida Spine, LLC)
• Our Home at Beacon Hill BSLC LLC
• Pancare of Florida, Inc (PanCare Rx Port St. Joe)

• Neonatal-Perinatal Medicine Physician in Port St Joe, FL
• Providers in Port St Joe, FL by specialty
• Neonatal-Perinatal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.