Individual provider Active NPI

Sonia Rae Boris, ARNP

  • Nurse Practitioner
  • Vestavia Hills, AL
National Provider Identifier
1396117693
Registry record updated Aug 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
9318208 Issued in FL
Practice address
2090 Columbiana Rd
Vestavia Hills, AL 35216-2153
Phone
(702) 918-6534
NPI assigned
Oct 26, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 9318208 FL Primary

Addresses

Primary practice location

2090 Columbiana Rd
Vestavia Hills, AL 35216-2153

Mailing address

PO Box 860069
St Augustine, FL 32086-0069
Phone (904) 819-4082

Other names 1

  • Sonia Reisdorf Former name

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
I20161111000723 FL Practitioner - Nurse Practitioner 0345529509 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9318208FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Sea Mental Health Practitioners LLC CurrentSince Mar 8, 2025 Accepting new patients
Davis Chiropractic Center Inc CurrentSince Dec 8, 2024 Accepting new patients
Bailey Chiropractic Life Center Inc. PastSince Apr 1, 2017 Accepting new patients

Locations

381 Palm Coast Pkwy SW
Unit 2
Palm Coast, FL 32137
Phone (386) 232-8089

Interoperability endpoints

  • Direct secure messaging: sonia.reisdorf@202362935902212.direct.elationemr.com

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": "1445817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785888000000",
    "number": "1396117693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 860069",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320860069",
            "telephone_number": "904-819-4082",
            "fax_number": "904-819-5056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2090 COLUMBIANA RD",
            "city": "VESTAVIA HILLS",
            "state": "AL",
            "postal_code": "352162153",
            "telephone_number": "702-918-6534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORIS",
        "first_name": "SONIA",
        "middle_name": "RAE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-26",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "9318208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SONIA",
            "last_name": "REISDORF",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Vestavia Hills, AL

Sources for this page

Verify at the official NPI Registry.