Individual provider Active NPI

Nancy M. Fusillo, ARNP

  • Family Nurse Practitioner
  • New Port Richey, FL
National Provider Identifier
1396767620
Registry record updated Apr 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP 1743292 Issued in FL
Practice address
5509 Grand Blvd
Suite 300
New Port Richey, FL 34652-3836
Phone
(727) 232-0644
Fax
(888) 546-0488
NPI assigned
Jul 24, 2006
Last updated
Apr 30, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP 1743292 FL Primary
Gerontology Nurse Practitioner 363LG0600X ARNP 1743292 FL

Addresses

Primary practice location

5509 Grand Blvd
Suite 300
New Port Richey, FL 34652-3836

Mailing address

6050 1St Ave S
Apt 34
St Petersburg, FL 33707-1636

Other identifiers 2

IdentifierTypeStateIssuer
000977000MedicaidFL
1396767620OtherNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP 1743292FLMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
All Smiles Sleep Solutions LLC CurrentSince Aug 1, 2021 Accepting new patients
The Healthcaring Clinic of Florida, LLC Family Past Accepting new patients
The Hospice of the Florida Suncoast, Inc. Past Accepting new patients
Empath Health Pharmaceuticals, LLC Past Accepting new patients

Locations

802 N Belcher Rd
Clearwater, FL 33765
Phone (727) 447-3000

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367280000000",
    "number": "1396767620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6050 1ST AVE S",
            "address_2": "APT 34",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337071636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5509 GRAND BLVD",
            "address_2": "SUITE 300",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346523836",
            "telephone_number": "727-232-0644",
            "fax_number": "888-546-0488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUSILLO",
        "first_name": "NANCY",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2013-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP 1743292",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "ARNP 1743292",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000977000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1396767620",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Port Richey, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.