Individual provider Active NPI

Nicole J Syverson

  • Gerontology Nurse Practitioner
  • Bradenton, FL
National Provider Identifier
1427939180
Registry record updated Sep 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APRN11041927 Issued in FL
Practice address
12832 True Blue Cir
Bradenton, FL 34211-1243
Phone
(847) 532-8705
NPI assigned
Sep 9, 2025
Last updated
Sep 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X APRN11041927 FL Primary

Addresses

Primary practice location

12832 True Blue Cir
Bradenton, FL 34211-1243

Mailing address

12832 True Blue Cir
Bradenton, FL 34211-1243
Phone (847) 532-8705

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
I20251029004928 FL Practitioner - Nurse Practitioner 9739678723 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

778 Liberty Rd
Flowood, MS 39232-9321

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11041927FLMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wound Management Specialists, LLC CurrentSince Oct 1, 2025 Accepting new patients

Locations

778 Liberty Rd
Flowood, MS 39232
Phone (601) 326-1794

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1757376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757376000000",
    "number": "1427939180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12832 TRUE BLUE CIR",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342111243",
            "telephone_number": "847-532-8705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12832 TRUE BLUE CIR",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342111243",
            "telephone_number": "847-532-8705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SYVERSON",
        "first_name": "NICOLE",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-09",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "APRN11041927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.