Organization Active NPI

Go Grow Live, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1457928491
Registry record updated Jun 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
GO GROW LIVE, LLC
Practice address
12015 Whitmarsh LN
Tampa, FL 33626-1737
Phone
(813) 587-0605
NPI assigned
Jun 8, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2021

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

Authorized official

Name
Erica Hand, APRNNPI 1578932133
Title
Ceo
Phone
(813) 407-6074

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

12015 Whitmarsh LN
Tampa, FL 33626-1737

Mailing address

12114 Rustic River Way
Tampa, FL 33635-9534

Other identifiers 1

IdentifierTypeStateIssuer
109361900MedicaidFL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1623110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623110400000",
    "number": "1457928491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12114 RUSTIC RIVER WAY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336359534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12015 WHITMARSH LN",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336261737",
            "telephone_number": "813-587-0605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GO GROW LIVE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-08",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A",
        "authorized_official_last_name": "HAND",
        "authorized_official_first_name": "ERICA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "813-407-6074",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109361900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.