Individual provider Active NPI

Santi Rekha Chellu, FNP

  • Nurse Practitioner
  • Fern Park, FL
National Provider Identifier
1437542750
Registry record updated Feb 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP9368774 Issued in FL
Practice address
2915 Lakeview Dr # 1001
Fern Park, FL 32730-2009
Phone
(407) 900-0613
Fax
(407) 335-6945
NPI assigned
Mar 11, 2015
Last updated
Feb 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP9368774 FL Primary

Addresses

Primary practice location

2915 Lakeview Dr # 1001
Fern Park, FL 32730-2009

Mailing address

2915 Lakeview Dr # 1001
Fern Park, FL 32730-2009
Phone (407) 900-0613

Other identifiers 2

IdentifierTypeStateIssuer
ARNP9368774OtherFLMEDICAL LICENSE
017298700MedicaidFL

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
I20160713000325 FL Practitioner - Nurse Practitioner 3375835291 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9368774FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc CurrentSince May 2, 2016 Accepting new patients
Inpatient Consultants of Florida, Inc Nurse Practitioner CurrentSince Feb 4, 2019 Accepting new patients
Inpatient Consultants of Florida Inc CurrentSince Feb 4, 2019 Accepting new patients
Orlando Health Medical Group Inc CurrentSince May 2, 2016 Accepting new patients

Locations

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

733 S Goldenrod Rd
Ste B
Orlando, FL 32822
Phone (407) 249-7999

86 Underwood St
Orlando, FL 32806
Phone (321) 841-5142

1401 W Seminole Blvd
Sanford, FL 32771
Phone (317) 805-2316

6000 49th St N
St Petersburg, FL 33709
Phone (727) 521-4411

3030 W Bearss Ave
Tampa, FL 33618
Phone (813) 932-2222

Organizations & group practices 4

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": "1426032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612224000000",
    "number": "1437542750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2915 LAKEVIEW DR # 1001",
            "city": "FERN PARK",
            "state": "FL",
            "postal_code": "327302009",
            "telephone_number": "407-900-0613",
            "fax_number": "321-407-6945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2915 LAKEVIEW DR # 1001",
            "city": "FERN PARK",
            "state": "FL",
            "postal_code": "327302009",
            "telephone_number": "407-900-0613",
            "fax_number": "407-335-6945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHELLU",
        "first_name": "SANTI",
        "middle_name": "REKHA",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-11",
        "last_updated": "2021-02-02",
        "certification_date": "2021-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9368774",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "ARNP9368774",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "017298700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fern Park, FL

Sources for this page

Verify at the official NPI Registry.