Individual provider Active NPI

Deirdre E Sweeney, NP

  • Adult Health Nurse Practitioner
  • Crystal River, FL
National Provider Identifier
1457312035
Registry record updated Feb 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
252200 Issued in MA
Practice address
6201 N Suncoast Blvd
Seven Rivers Regional Medical Center
Crystal River, FL 34428-6712
Phone
(617) 997-7467
NPI assigned
Mar 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 252200 MA
Adult Health Nurse Practitioner 363LA2200X 252200 MA Primary
Gerontology Nurse Practitioner 363LG0600X 252200 MA

Addresses

Primary practice location

6201 N Suncoast Blvd
Seven Rivers Regional Medical Center
Crystal River, FL 34428-6712

Mailing address

6201 N Suncoast Blvd
Seven Rivers Regional Medical Center
Crystal River, FL 34428-6712
Phone (617) 997-7467

Other identifiers 3

IdentifierTypeStateIssuer
0703419MedicaidMA
AA30382OtherMAHARVARD PILGRIM
NP4571OtherMABLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040628001310 MA Practitioner - Nurse Practitioner 9335125533 Reassigns benefits to 1 organization
I20171220000512 FL Practitioner - Nurse Practitioner 9335125533 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
252200MAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Simed Health LLC CurrentSince Oct 1, 2019 Accepting new patients
Simedhealth LLC CurrentSince Oct 1, 2019 Accepting new patients
Pophealthcare, LLC Past Accepting new patients

Locations

4881 NW 8th Ave
Ste 2
Gainesville, FL 32605
Phone (352) 373-6338

4343 Newberry Rd
Gainesville, FL 32607
Phone (352) 224-2200

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486684800000",
    "number": "1457312035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 N SUNCOAST BLVD",
            "address_2": "SEVEN RIVERS REGIONAL MEDICAL CENTER",
            "city": "CRYSTAL RIVER",
            "state": "FL",
            "postal_code": "344286712",
            "telephone_number": "617-997-7467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6201 N SUNCOAST BLVD",
            "address_2": "SEVEN RIVERS REGIONAL MEDICAL CENTER",
            "city": "CRYSTAL RIVER",
            "state": "FL",
            "postal_code": "344286712",
            "telephone_number": "617-997-7467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWEENEY",
        "first_name": "DEIRDRE",
        "middle_name": "E",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-31",
        "last_updated": "2017-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "252200",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "252200",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MA",
            "license": "252200",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0703419",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "AA30382",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "NP4571",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal River, FL

Sources for this page

Verify at the official NPI Registry.