Individual provider Active NPI

Lakisha Denise Coney, ARNP

  • Adult Health Nurse Practitioner
  • Hollywood, FL
National Provider Identifier
1407017114
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
9203065 Issued in FL
Practice address
1150 N 35TH Ave
Suite 605
Hollywood, FL 33021-5424
Phone
(954) 265-7900
Fax
(954) 276-0252
NPI assigned
Jun 24, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 9203065 FL Primary

Addresses

Primary practice location

1150 N 35TH Ave
Suite 605
Hollywood, FL 33021-5424

Mailing address

2900 Corporate Way
Door D
Miramar, FL 33025
Phone (954) 276-5663

Other identifiers 1

IdentifierTypeStateIssuer
002922300MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lconey151090@MHSDIRECT.NET Direct

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
I20101210000507 FL Practitioner - Nurse Practitioner 3971790346 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Broward Hospital DistrictGroup PAC ID 8123927373, 659 clinicians
Seasons Medical Group of Florida PAGroup PAC ID 0941451314, 44 clinicians

Practice addresses (Care Compare)

1150 N 35TH Ave
Suite 605
Hollywood, FL 33021-5431
Phone (954) 265-7900

1200 S Pine Island Rd
Suite 350
Plantation, FL 33324-4409
Phone (954) 624-7900

Hospital & facility affiliations

  • Memorial Regional Hospital Hospital, Hollywood, FL, CCN 100038
  • Memorial Hospital West Hospital, Pembroke Pines, FL, CCN 100281
  • Memorial Hospital Miramar Hospital, Miramar, FL, CCN 100285

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9203065FLMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Seasons Hospice & Palliative Care of Broward Florida LLC CurrentSince Aug 7, 2024 Accepting new patients
South Broward Hospital District CurrentSince Jun 6, 2017 Accepting new patients
South Broward Hospital District CurrentSince Jun 6, 2017 Accepting new patients
Seasons Medical Group of Florida PA CurrentSince Aug 7, 2024 Accepting new patients

Locations

1815 Griffin Rd
Ste 410
Dania Beach, FL 33004
Phone (954) 624-7900

1150 N 35th Ave
Ste 605
Hollywood, FL 33021
Phone (954) 965-2966

2900 Corporate Way
#D
Miramar, FL 33025
Phone (954) 276-5581

1200 S Pine Island Rd
Ste 350
Plantation, FL 33324
Phone (305) 223-2000

17855 Dallas Pkwy
Ste 200
Dallas, TX 75287
Phone (972) 201-3800

Interoperability endpoints

  • Direct secure messaging: lconey151090@mhsdirect.net

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 and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1214265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1407017114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 CORPORATE WAY",
            "address_2": "DOOR D",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "33025",
            "telephone_number": "954-276-5663",
            "fax_number": "954-276-0301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 N 35TH AVE",
            "address_2": "SUITE 605",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330215424",
            "telephone_number": "954-265-7900",
            "fax_number": "954-276-0252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONEY",
        "first_name": "LAKISHA",
        "middle_name": "DENISE",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-24",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "9203065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002922300",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lconey151090@MHSDIRECT.NET",
            "affiliation": "N",
            "endpointDescription": "MHS DSM",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1150 N 35th Ave",
            "address_2": "SUITE 605",
            "city": "Hollywood",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330215424",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.