Individual provider Active NPI

Rhiannon M Fahey, APRN

  • Gerontology Nurse Practitioner
  • Trinity, FL
National Provider Identifier
1376935692
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APRN9172756 Issued in FL
Practice address
9320 State Road 54
Trinity, FL 34655-1808
Phone
(727) 842-8411
Fax
(877) 917-2336
NPI assigned
Feb 24, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN9172756 FL
Gerontology Nurse Practitioner 363LG0600X APRN9172756 FL Primary

Addresses

Primary practice location

9320 State Road 54
Trinity, FL 34655-1808

Mailing address

PO Box 102222
Atlanta, GA 30368-2222
Phone (239) 274-8200

Other practice location 1

7651 Medical Dr
Hudson, FL 34667-6594
Phone (727) 868-9208

Other identifiers 1

IdentifierTypeStateIssuer
109385800MedicaidFL

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
I20160601002146 FL Practitioner - Nurse Practitioner 2860782943 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Cancer Specialists and Research Institute, LLCGroup PAC ID 2567356058, 464 clinicians

Practice addresses (Care Compare)

7651 Medical Dr
Hudson, FL 34667-6594
Phone (727) 868-9208

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN9172756FLMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Cancer Specialists & Research Institute, LLC CurrentSince Mar 20, 2016 Accepting new patients
Florida Cancer Specialists & Research Institute, LLC Past Accepting new patients

Locations

7651 Medical Dr
Fl Cancer
Hudson, FL 34667
Phone (727) 868-9208

7651 Medical Dr
Hudson, FL 34667
Phone (727) 868-9208

4420 Sun N Lake Blvd
Fl Cancer
Sebring, FL 33872
Phone (863) 385-1244

7154 Medical Center Dr
Spring Hill, FL 34608
Phone (352) 596-1926

8763 River Crossing Blvd
Trinity, FL 34655
Phone (727) 788-4350

9320 State Road 54
Trinity, FL 34655
Phone (727) 493-2513

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.

NPI Registry JSON

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

{
    "created_epoch": "1424736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1376935692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 102222",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303682222",
            "telephone_number": "239-274-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9320 STATE ROAD 54",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346551808",
            "telephone_number": "727-842-8411",
            "fax_number": "877-917-2336"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7651 Medical Dr",
            "address_purpose": "LOCATION",
            "city": "Hudson",
            "state": "FL",
            "postal_code": "346676594",
            "country_code": "US",
            "telephone_number": "727-868-9208",
            "fax_number": "727-868-6420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAHEY",
        "first_name": "RHIANNON",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-24",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN9172756",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "APRN9172756",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109385800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Trinity, FL

Sources for this page

Verify at the official NPI Registry.