Individual provider Active NPI

Maximillian Luke Covert, APRN

  • Acute Care Nurse Practitioner
  • Largo, FL
National Provider Identifier
1356825632
Registry record updated Feb 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
9490053 Issued in FL
Practice address
1301 2ND Ave SW Ste 315
Largo, FL 33770-3120
Phone
(727) 587-7120
Fax
(727) 585-6850
NPI assigned
Sep 21, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X APRN9490053 FL
Acute Care Nurse Practitioner 363LA2100X APRN9490053 FL
Primary Care Nurse Practitioner 363LP2300X APRN9490053 FL
Acute Care Nurse Practitioner 363LA2100X 9490053 FL Primary

Addresses

Primary practice location

1301 2ND Ave SW Ste 315
Largo, FL 33770-3120

Mailing address

6250 Park Blvd N
Pinellas Park, FL 33781-3237
Phone (727) 541-2520

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
I20181109001888 FL Practitioner - Nurse Practitioner 1850645854 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9490053FLMDAcute Care Nurse Practitioner
APRN9490053FLMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf Coast Rehabilitation and Wellness Center Inc CurrentSince Apr 25, 2019 Accepting new patients
Community Hospital Family Practice LLC CurrentSince Jan 15, 2019 Accepting new patients
Gulf Coast Physical Medicine, Inc. PastSince Apr 25, 2019 Accepting new patients

Locations

7515 State Road 52
Ste 102
Hudson, FL 34667
Phone (727) 842-3322

1301 2nd Ave SW
Ste 315
Largo, FL 33770
Phone (727) 587-7120

2385 Tampa Rd
Ste 1
Palm Harbor, FL 34683
Phone (727) 541-2520

6250 Park Blvd N
Pinellas Park, FL 33781
Phone (727) 541-2520

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

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": "1537488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645488000000",
    "number": "1356825632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6250 PARK BLVD N",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337813237",
            "telephone_number": "727-541-2520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 2ND AVE SW STE 315",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337703120",
            "telephone_number": "727-587-7120",
            "fax_number": "727-585-6850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COVERT",
        "first_name": "MAXIMILLIAN",
        "middle_name": "LUKE",
        "name_prefix": "Mr.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-21",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "APRN9490053",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "APRN9490053",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "APRN9490053",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "9490053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

Verify at the official NPI Registry.