Individual provider Active NPI

Constance Ann Bumiller, ARNP

  • Family Nurse Practitioner
  • Seminole, FL
National Provider Identifier
1427189695
Registry record updated Sep 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2685832 Issued in FL
Practice address
7939 Harwood Rd
Seminole, FL 33777-3102
Phone
(727) 432-3449
Fax
(727) 397-0718
NPI assigned
Mar 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2014

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 2685832 FL Primary

Addresses

Primary practice location

7939 Harwood Rd
Seminole, FL 33777-3102

Mailing address

5220 Belfort Rd
Ste 130
Jacksonville, FL 32256-6017
Phone (727) 867-5480

Other identifiers 2

IdentifierTypeStateIssuer
308215600MedicaidFL
Y114AOtherFLBCBS

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

LicenseStateTypeSpecialty
2685832FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Your Care Clinics LLC Past Accepting new patients
Advanced Wound Systems LLC PastSince Sep 8, 2008 Accepting new patients
Wayne J. Garcia Mdpa Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411084800000",
    "number": "1427189695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5220 BELFORT RD",
            "address_2": "STE 130",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566017",
            "telephone_number": "727-867-5480",
            "fax_number": "888-507-9833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7939 HARWOOD RD",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337773102",
            "telephone_number": "727-432-3449",
            "fax_number": "727-397-0718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUMILLER",
        "first_name": "CONSTANCE",
        "middle_name": "ANN",
        "name_prefix": "Miss",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2014-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "2685832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "308215600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Y114A",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seminole, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2014; 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.