Individual provider Active NPI

Melanie Renee Root

  • Nurse Practitioner
  • Winter Park, FL
National Provider Identifier
1457738379
Registry record updated Jul 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP9189454 Issued in FL
Practice address
483 N Semoran Blvd
102
Winter Park, FL 32792-3800
Phone
(407) 645-1847
NPI assigned
Apr 29, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X ARNP9189454 FL
Adult Health Nurse Practitioner 363LA2200X ARNP9189454 ZZ
Gerontology Nurse Practitioner 363LG0600X ARNP9189454 FL
Nurse Practitioner 363L00000X ARNP9189454 FL Primary

Addresses

Primary practice location

483 N Semoran Blvd
102
Winter Park, FL 32792-3800

Mailing address

483 N Semoran Blvd
102
Winter Park, FL 32792-3800
Phone (407) 645-1847

Other names 1

  • Melanie Ahmanson Former name

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
I20150609001678 FL Practitioner - Nurse Practitioner 9234450792 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9189454FLMDAcute Care Nurse Practitioner
ARNP9189454ZZMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
US Anesthesia Partners of Florida Inc. CurrentSince Dec 1, 2016 Accepting new patients
Florida Cardiology PA CurrentSince Apr 11, 2015 Accepting new patients

Locations

306 S 10th St
Haines City, FL 33844
Phone (941) 419-1418

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

7806 Lake Underhill Rd
Ste 105
Orlando, FL 32822
Phone (407) 281-9229

483 N Semoran Blvd
Ste 102
Winter Park, FL 32792

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 2

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": "1430265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1457738379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "483 N SEMORAN BLVD",
            "address_2": "102",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327923800",
            "telephone_number": "407-645-1847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "483 N SEMORAN BLVD",
            "address_2": "102",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327923800",
            "telephone_number": "407-645-1847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROOT",
        "first_name": "MELANIE",
        "middle_name": "RENEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-29",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "ARNP9189454",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "ZZ",
            "license": "ARNP9189454",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "ARNP9189454",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9189454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELANIE",
            "last_name": "AHMANSON",
            "credential": "ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Winter Park, FL

Sources for this page

Verify at the official NPI Registry.