Individual provider Active NPI

Roshanda K. Ivey, APRN

  • Family Nurse Practitioner
  • Daytona Beach, FL
National Provider Identifier
1417472242
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11009805 Issued in FL
Practice address
1001 Great Oaks Dr
Daytona Beach, FL 32117-3124
Phone
(386) 334-0095
Fax
(386) 246-7418
NPI assigned
Aug 14, 2017
Last updated
Mar 31, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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 APRN11009805 FL Primary
Case Manager/Care Coordinator 171M00000X FL

Addresses

Primary practice location

1001 Great Oaks Dr
Daytona Beach, FL 32117-3124

Mailing address

1001 Great Oaks Dr
Daytona Beach, FL 32117-3124
Phone (386) 334-0095

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
I20210505001188 FL Practitioner - Nurse Practitioner 1850700733 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1001 Great Oaks Dr
Daytona Beach, FL 32117-3124
Phone (888) 530-0746

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Capstone Healthcare,L.L.C CurrentSince Oct 24, 2021 Accepting new patients
House Call M.D.'S L.L.C. CurrentSince Nov 1, 2022 Accepting new patients
Chma of FL, PLLC CurrentSince Jun 27, 2022 Accepting new patients

Locations

2777 NE 183rd St
Aventura, FL 33160
Phone (305) 405-2014

2400 Maitland Center Pkwy
Ste 310
Maitland, FL 32751
Phone (352) 329-1800

909 Ridgebrook Rd
Ste 300
Sparks Glencoe, MD 21152
Phone (443) 483-9300

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

Hospital & facility affiliations 1

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": "1502668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1417472242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 GREAT OAKS DR",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321173124",
            "telephone_number": "386-334-0095",
            "fax_number": "386-246-7418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 GREAT OAKS DR",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321173124",
            "telephone_number": "386-334-0095",
            "fax_number": "386-246-7418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVEY",
        "first_name": "ROSHANDA",
        "middle_name": "K.",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-14",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11009805",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "FL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.