Noelle Klawon Riesen

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11005813 Issued in FL

Practice address

12196 County Road 512
Fellsmere, FL 32948-5463

Phone

(772) 257-8224

Fax

(772) 252-3245

NPI assigned

Aug 19, 2020

Last updated

Jan 10, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ms. Noelle Klawon Manese Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: noelle.riesen.1@14940.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Treasure Coast Community Health Inc

  • Federally Qualified Health Center (FQHC)
  • Fellsmere, FL
  • NPI 1891740916
  Medicare reassignment NPD
• Florida Department of Health

  dba Levy County Health Department

  • Public Health or Welfare Agency
  • Bronson, FL
  • NPI 1154395390
  NPD
• Florida Department of Health

  • Public Health or Welfare Agency
  • Defuniak Springs, FL
  • NPI 1790746535
  NPD
• Treasure Coast Community Health Inc

  • Federally Qualified Health Center (FQHC)
  • Vero Beach, FL
  • NPI 1609686542
  NPD
• Treasure Coast Community Health Inc

  • Federally Qualified Health Center (FQHC)
  • Vero Beach, FL
  • NPI 1649721341
  NPD

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

{
    "created_epoch": "1597795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1386256485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 INDIAN RIVER BLVD STE B210",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329607113",
            "telephone_number": "772-257-8224",
            "fax_number": "772-252-3245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12196 COUNTY ROAD 512",
            "city": "FELLSMERE",
            "state": "FL",
            "postal_code": "329485463",
            "telephone_number": "772-257-8224",
            "fax_number": "772-252-3245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIESEN",
        "first_name": "NOELLE",
        "middle_name": "KLAWON",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-19",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11005813",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL HF MEDICARE",
            "identifier": "OW686",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NOELLE",
            "last_name": "MANESE",
            "middle_name": "KLAWON",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• LR Hart LLC
• Thomas A Netter, MD
• Susan Pinsky, MD
• Humberto Posada, M.D.
• Sonia Redio Rondon, APRN
• Amber Rowe, D.D.S.
• Saint Lucie Pediatrics Inc.
• Mariela Sanchez
• Leslie Sikaffy, LCSW
• Mia Starcevic, DMD

• Family Nurse Practitioner in Fellsmere, FL
• Providers in Fellsmere, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.