Individual provider Active NPI

Vilsy Thekkan, CRNP

  • Adult Health Nurse Practitioner
  • Apopka, FL
National Provider Identifier
1336704436
Registry record updated May 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APRN11007624 Issued in FL
Practice address
225 E 7TH St
Apopka, FL 32703-5327
Phone
(407) 905-8827
Fax
(407) 660-1667
NPI assigned
May 3, 2019
Last updated
May 11, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X APRN11007624 FL Primary
Gerontology Nurse Practitioner 363LG0600X SP019221 PA

Addresses

Primary practice location

225 E 7TH St
Apopka, FL 32703-5327

Mailing address

110 S Woodland St
Winter Garden, FL 34787-3546
Phone (407) 905-8827

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
I20220721001961 FL Practitioner - Nurse Practitioner 4688903826 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Centers, Inc Current Accepting new patients
Community Health Centers, Inc CurrentSince Apr 18, 2022 Accepting new patients
Community Health Centers, Inc Current Accepting new patients
Community Health Centers, Inc CurrentSince Apr 18, 2022 Accepting new patients

Locations

225 E 7th St
Apopka, FL 32703
Phone (407) 886-6201

7900 Forest City Rd
Orlando, FL 32810
Phone 40790588271001

840 Mercy Dr
Pine Hills, FL 32808
Phone 4079058827 ext. 2997

212 E Main St
Tavares, FL 32778
Phone (352) 314-7409

110 S Woodland St
Winter Garden, FL 34787

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1556841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652227200000",
    "number": "1336704436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 S WOODLAND ST",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347873546",
            "telephone_number": "407-905-8827",
            "fax_number": "407-905-8998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 E 7TH ST",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "327035327",
            "telephone_number": "407-905-8827",
            "fax_number": "407-660-1667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEKKAN",
        "first_name": "VILSY",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-03",
        "last_updated": "2022-05-11",
        "certification_date": "2022-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN11007624",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SP019221",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apopka, FL

Sources for this page

Verify at the official NPI Registry.