Active NPI
Nancy M. Fusillo, ARNP
- Family Nurse Practitioner
- New Port Richey, FL
National Provider Identifier
1396767620
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- ARNP 1743292
- 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, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000977000 | Medicaid | FL | |
| 1396767620 | Other | NPI |
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
| License | State | Type | Specialty |
|---|---|---|---|
| ARNP 1743292 | FL | MD | Gerontology Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| All Smiles Sleep Solutions LLC | Current | 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.
-
- Durable Medical Equipment & Medical Supplies
- Clearwater, FL
- NPI 1003589060
-
dba Empath Health Pharmaceuticals
- Community/Retail Pharmacy
- Largo, FL
- NPI 1407257470
-
- Family Nurse Practitioner
- Orange City, FL
- NPI 1003914441
-
- Community Based Hospice Care Agency
- Palm Harbor, FL
- NPI 1124028204
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.