Individual provider Active NPI

Deborahlin Huxtable, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Fort Myers, FL
National Provider Identifier
1477069516
Registry record updated Jun 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN9291074 Issued in FL
Practice address
2830 Winkler Ave Ste 207
Fort Myers, FL 33916-9301
Phone
(239) 215-4600
NPI assigned
Dec 27, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X APRN9291074 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN9291074 FL Primary

Addresses

Primary practice location

2830 Winkler Ave Ste 207
Fort Myers, FL 33916-9301

Mailing address

6360 Techster Blvd Ste 1
Fort Myers, FL 33966-4805
Phone (239) 223-2751

Other identifiers 1

IdentifierTypeStateIssuer
025099000MedicaidFL

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
I20180405000198 FL Practitioner - Nurse Practitioner 5799048765 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dna Comprehensive Therapy Services LLCGroup PAC ID 2860619632, 446 clinicians

Practice addresses (Care Compare)

4310 Metro Pkwy
Suite 205
Fort Myers, FL 33916-9416
Phone (239) 223-2751

Merit-based Incentive Payment System (MIPS)

Final score
87.43 of 100Reported as group
Quality
74.02
Promoting interoperability
100
Improvement activities
40
Cost
77.26

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN9291074FLMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dna Comprehensive Therapy Services, LLC CurrentSince Aug 6, 2018 Accepting new patients
Bonita Springs Retirement Village, Inc. CurrentSince Aug 6, 2018 Accepting new patients
Cape Coral Hospitalists Inc Past Accepting new patients

Locations

4310 Metro Pkwy
Ste 205
Fort Myers, FL 33916

2830 Winkler Ave
Ste 207
Fort Myers, FL 33916
Phone (239) 215-4600

6360 Techster Blvd
Ste 1
Fort Myers, FL 33966
Phone (238) 223-2751

3191 Harbor Blvd
Ste A
Pt Charlotte, FL 33952
Phone (941) 766-9555

Interoperability endpoints

  • Direct secure messaging: deborahlin.huxtable.1@13142.direct.athenahealth.com

Organizations & group practices 3

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": "1514332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559692800000",
    "number": "1477069516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6360 TECHSTER BLVD STE 1",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339664805",
            "telephone_number": "239-223-2751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2830 WINKLER AVE STE 207",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339169301",
            "telephone_number": "239-215-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUXTABLE",
        "first_name": "DEBORAHLIN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-27",
        "last_updated": "2019-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "APRN9291074",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN9291074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "025099000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.