Individual provider Active NPI

Alexandra Peach

  • Family Nurse Practitioner
  • Bartow, FL
National Provider Identifier
1336984046
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11033660 Issued in FL
Practice address
1528 Barnhorst Rd
Bartow, FL 33830-9437
Phone
(863) 409-0685
NPI assigned
Jun 26, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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 APRN11033660 FL Primary

Addresses

Primary practice location

1528 Barnhorst Rd
Bartow, FL 33830-9437

Mailing address

1528 Barnhorst Rd
Bartow, FL 33830-9437
Phone (863) 409-0685

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
I20240808002094 FL Practitioner - Nurse Practitioner 4688111586 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
WT Health of Florida LLC CurrentSince Mar 16, 2025 Accepting new patients
Wound Technology Network Inc CurrentSince Jul 29, 2024 Accepting new patients
Wound Technology Network Past Accepting new patients

Locations

200 S Park Rd
Ste 200
Hollywood, FL 33021
Phone (866) 986-2263

5979 Vineland Rd
Ste 109
Orlando, FL 32819
Phone (407) 270-7702

Organizations & group practices 3

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": "1719360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1336984046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1528 BARNHORST RD",
            "city": "BARTOW",
            "state": "FL",
            "postal_code": "338309437",
            "telephone_number": "863-409-0685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1528 BARNHORST RD",
            "city": "BARTOW",
            "state": "FL",
            "postal_code": "338309437",
            "telephone_number": "863-409-0685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEACH",
        "first_name": "ALEXANDRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-26",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11033660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bartow, FL

Sources for this page

Verify at the official NPI Registry.