Individual provider Active NPI

Evelyn Rose Warren

  • Adult Health Nurse Practitioner
  • The Villages, FL
National Provider Identifier
1346871597
Registry record updated Apr 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APRN11006206 Issued in FL
Practice address
3456 Neaptide Path
The Villages, FL 32163-6370
Phone
(352) 804-4108
NPI assigned
Jan 27, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN9445381 FL
Adult Health Nurse Practitioner 363LA2200X APRN11006206 FL Primary

Addresses

Primary practice location

3456 Neaptide Path
The Villages, FL 32163-6370

Mailing address

3456 Neaptide Path
The Villages, FL 32163-6370
Phone (352) 804-4108

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
I20220816001375 FL Practitioner - Nurse Practitioner 4284017740 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cora Health Services IncGroup PAC ID 1759290992, shared by 21 NPIs, 1,125 clinicians
The Orthopaedic Institute, PAGroup PAC ID 2860385242, 113 clinicians

Practice addresses (Care Compare)

1050 Old Camp Rd
Suite 282
The Villages, FL 32162-1762
Phone (352) 693-3378

146 SW Orthopedic CT
Lake City, FL 32024-0672
Phone (386) 755-9215

1710 SE 16TH Ave
Ocala, FL 34471-4656
Phone (352) 620-1900

17270 SE 109TH Terrace Rd
Summerfield, FL 34491-9015
Phone (352) 633-7222

2953 Traverse TRL
The Villages, FL 32163-2017
Phone (352) 693-3378

2955 Brownwood Blvd
Suite 403
The Villages, FL 32163-2040
Phone (352) 336-6000

8768 SE 165TH Mulberry LN
Cora Physical Therapy Mulberry Lane
The Villages, FL 32162-5861
Phone (352) 329-5237

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.3 of 100Reported as group
Promoting interoperability
98
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN9445381FLMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
The Orthopaedic Institute PA CurrentSince Aug 1, 2022 Accepting new patients
The Orthopaedic Institute, PA CurrentSince Aug 1, 2022 Accepting new patients

Locations

4500 Newberry Rd
Gainesville, FL 32607
Phone (352) 367-2310

146 SW Orthopedic Ct
Lake City, FL 32024
Phone (386) 755-9215

17270 SE 109th Terrace Rd
Summerfield, FL 34491
Phone (352) 336-0000

2955 Brownwood Blvd
Ste 403
The Villages, FL 32163
Phone (352) 674-8700

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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 1

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": "1580083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587427200000",
    "number": "1346871597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3456 NEAPTIDE PATH",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321636370",
            "telephone_number": "352-804-4108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3456 NEAPTIDE PATH",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321636370",
            "telephone_number": "352-804-4108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARREN",
        "first_name": "EVELYN",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-27",
        "last_updated": "2020-04-21",
        "certification_date": "2020-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9445381",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN11006206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in The Villages, FL

Sources for this page

Verify at the official NPI Registry.