Individual provider Active NPI

Robert Jason Epperson

  • Family Nurse Practitioner
  • Port Saint Lucie, FL
National Provider Identifier
1417690132
Registry record updated Apr 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11013999 Issued in FL
Practice address
4801 NW Gimlet Ave
Port Saint Lucie, FL 34983-1336
Phone
(407) 729-4835
NPI assigned
Apr 20, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11013999 FL Primary

Addresses

Primary practice location

4801 NW Gimlet Ave
Port Saint Lucie, FL 34983-1336

Mailing address

4801 NW Gimlet Ave
Port Saint Lucie, FL 34983-1336

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
I20220506000069 FL Practitioner - Nurse Practitioner 6002293313 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mobile Medical Operating Company LLCGroup PAC ID 1456747625, 11 clinicians

Practice addresses (Care Compare)

1840 SE Port St Lucie Blvd
Suite 1840
Port St Lucie, FL 34952-5545
Phone (772) 221-7620

Hospital & facility affiliations

  • Trilogy Home Healthcare Home health agency, Port Saint Lucie, FL, CCN 109270
  • Concierge Home Care Home health agency, Port Saint Lucie, FL, CCN 687163
  • Elite Home Health Group Inc Home health agency, Boca Raton, FL, CCN 109710
  • Community Home Health Services Home health agency, Lake Worth, FL, CCN 107325
  • Anchor Home Health Services, LLC Home health agency, Stuart, FL, CCN 107747
  • Cleveland Clinic Martin North Hospital Hospital, Stuart, FL, CCN 100044

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11013999FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mobile Medical Operating Company LLC CurrentSince Jul 8, 2022 Accepting new patients

Locations

4655 Salisbury Rd
Ste 110
Jacksonville, FL 32256
Phone (904) 570-9404

1840 SE Port St Lucie Blvd
Ste 1840
Port St Lucie, FL 34952
Phone (772) 221-7620

Organizations & group practices 1

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 6

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": "1650412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1417690132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 NW GIMLET AVE",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349831336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 NW GIMLET AVE",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349831336",
            "telephone_number": "407-729-4835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EPPERSON",
        "first_name": "ROBERT",
        "middle_name": "JASON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-20",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11013999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

Verify at the official NPI Registry.