Express Provider Services PLLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

EXPRESS PROVIDER SERVICES PLLC

Practice address

8130 Lakewood Main St Ste 103
Lakewood Ranch, FL 34202-5068

Phone

(407) 221-1679

NPI assigned

Apr 28, 2022

Last updated

Aug 17, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Ashley Raley, APRNNPI 1831595016

Title

Owner

Phone

(407) 221-1679

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/26533/brand/1/csg/1/fhir/r4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ashley R Raley, APRN, FNP-C

  • Family Nurse Practitioner
  • Tampa, FL
  • NPI 1831595016
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1651104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660694400000",
    "number": "1427793181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8130 LAKEWOOD MAIN ST STE 103",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342025068",
            "telephone_number": "407-221-1679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8130 LAKEWOOD MAIN ST STE 103",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342025068",
            "telephone_number": "407-221-1679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXPRESS PROVIDER SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-28",
        "last_updated": "2022-08-17",
        "certification_date": "2022-08-17",
        "status": "A",
        "authorized_official_last_name": "RALEY",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-221-1679",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN LICENSE",
            "identifier": "9298097",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Lakewood Ranch, FL
• Providers in Lakewood Ranch, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.