Individual provider Active NPI

Gloria Ann Pena, ARNP

  • Nurse Practitioner
  • Belleview, FL
National Provider Identifier
1437358496
Registry record updated Sep 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP1473752 Issued in FL
Practice address
6262 SE 121St PL
Belleview, FL 34420-5215
Phone
(800) 385-1347
NPI assigned
Jul 11, 2007
Last updated
Sep 23, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP1473752 FL Primary
Family Nurse Practitioner 363LF0000X ARNP1473752 FL

Addresses

Primary practice location

6262 SE 121St PL
Belleview, FL 34420-5215

Mailing address

7970 SW 62ND CT
Ocala, FL 34476-5532
Phone (954) 913-1111

Other practice location 1

7970 SW 62nd Ct
Ocala, FL 34476-5532
Phone (954) 913-1111

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
I20071108000228 FL Practitioner - Nurse Practitioner 0547358533 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

6262 SE 121 Place
Belleview, FL 34420-5215
Phone (800) 385-1247

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP1473752FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness Health Providers,Apn.House Calls,LLC. Nurse Practitioner CurrentSince Apr 1, 2015 Accepting new patients
Eladio Dieguez MD PA PastSince Sep 1, 2015 Accepting new patients
Florida Medical Associates LLC Past Accepting new patients
Advantage Wellness Services Nurse Practitioner Past Accepting new patients
Rural Medical Associates Inc Past Accepting new patients

Locations

6262 SE 121st Pl
Belleview, FL 34420
Phone (352) 415-2510

Organizations & group practices 5

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": "1184112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600819200000",
    "number": "1437358496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7970 SW 62ND CT",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344765532",
            "telephone_number": "954-913-1111",
            "fax_number": "352-415-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6262 SE 121ST PL",
            "city": "BELLEVIEW",
            "state": "FL",
            "postal_code": "344205215",
            "telephone_number": "800-385-1347"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7970 SW 62nd Ct",
            "address_purpose": "LOCATION",
            "city": "Ocala",
            "state": "FL",
            "postal_code": "344765532",
            "country_code": "US",
            "telephone_number": "954-913-1111",
            "fax_number": "352-854-1189",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENA",
        "first_name": "GLORIA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-11",
        "last_updated": "2020-09-23",
        "certification_date": "2020-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP1473752",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP1473752",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleview, FL

Sources for this page

Verify at the official NPI Registry.