Individual provider Active NPI

Amy Danielle Dobberfuhl, APRN CPNP-PC

  • Pediatric Nurse Practitioner
  • Ormond Beach, FL
National Provider Identifier
1407455017
Registry record updated Jan 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
APRN11011710 Issued in FL
Practice address
725 W Granada Blvd Ste 1
Ormond Beach, FL 32174-9406
Phone
(386) 673-2770
Fax
(386) 673-2760
NPI assigned
Oct 23, 2020
Sex
Female
Sole proprietor
No

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.

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
APRN11011710FLMDNurse Practitioner
C160938IAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Acute Care Pediatrics of Palm Coast, PA Past Accepting new patients
North Florida Pediatrics, PA Past Accepting new patients
North Florida Pediatrics, PA Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: amy.dobberfuhl.p1@direct.nfpeds.nextgenshare.com

Specialties & licenses 3

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X APRN11011710 FL Primary
Pediatric Nurse Practitioner 363LP0200X C160938 IA
Nurse Practitioner 363L00000X APRN11011710 FL

Addresses

NPPES NPI Registry

Primary practice location

725 W Granada Blvd Ste 1
Ormond Beach, FL 32174-9406

Mailing address

900 S Pine Island Rd Ste 800
Plantation, FL 33324-3923
Phone (386) 673-2770

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
109628600MedicaidFL

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 22, 2026.

{
    "created_epoch": "1603411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769040000000",
    "number": "1407455017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 S PINE ISLAND RD STE 800",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333243923",
            "telephone_number": "386-673-2770",
            "fax_number": "386-673-2760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 W GRANADA BLVD STE 1",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321749406",
            "telephone_number": "386-673-2770",
            "fax_number": "386-673-2760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOBBERFUHL",
        "first_name": "AMY",
        "middle_name": "DANIELLE",
        "credential": "APRN CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-23",
        "last_updated": "2026-01-22",
        "certification_date": "2026-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "APRN11011710",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IA",
            "license": "C160938",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11011710",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109628600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ormond Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2026; 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.