Individual provider Active NPI

Cathy J Eagle, MSN

  • Family Nurse Practitioner
  • Mount Dora, FL
National Provider Identifier
1366729402
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN9234522 Issued in FL
Practice address
18450 US Highway 441
Mount Dora, FL 32757-6707
Phone
(352) 383-1667
NPI assigned
Nov 3, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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 APRN9234522 FL Primary

Addresses

Primary practice location

18450 US Highway 441
Mount Dora, FL 32757-6707

Mailing address

18450 US Highway 441
Mount Dora, FL 32757-6707
Phone (352) 383-1667

Other identifiers 1

IdentifierTypeStateIssuer
ARNP9234522OtherFLLICENSE

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
I20111227000044 FL Practitioner - Nurse Practitioner 4082880976 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aegis Medical Group LLCGroup PAC ID 8022324862, 20 clinicians

Practice addresses (Care Compare)

4685 N County Rd
19A
Mount Dora, FL 32757-2039
Phone (352) 483-0900

Hospital & facility affiliations

  • Adventhealth Waterman Hospital, Tavares, FL, CCN 100057
  • Adventhealth Daytona Beach Hospital, Daytona Beach, FL, CCN 100068
  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN9234522FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aegis Medical Group LLC CurrentSince Apr 11, 2023 Accepting new patients

Locations

410 Fern Dr
Leesburg, FL 34748
Phone (352) 218-8200

711 N 3rd St
Ste 2
Leesburg, FL 34748
Phone (352) 360-1725

18550 US Highway 441
Mount Dora, FL 32757
Phone (352) 735-3755

4685 N Highway 19A
Mount Dora, FL 32757
Phone (352) 483-0900

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JBDHAD

Organizations & group practices 1

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 5

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": "1320278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1366729402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18450 US HIGHWAY 441",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327576707",
            "telephone_number": "352-383-1667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18450 US HIGHWAY 441",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327576707",
            "telephone_number": "352-383-1667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EAGLE",
        "first_name": "CATHY",
        "middle_name": "J",
        "credential": "MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-03",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9234522",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "ARNP9234522",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Dora, FL

Sources for this page

Verify at the official NPI Registry.