Individual provider Active NPI

Julie Totterdale Anderson, DNP

  • Family Nurse Practitioner
  • Melbourne, FL
National Provider Identifier
1477897692
Registry record updated May 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP 9225132 Issued in FL
Practice address
3040 N Wickham Rd Ste 10
Wickham Executive Center
Melbourne, FL 32935-2369
Phone
(321) 428-4840
Fax
(321) 428-4841
NPI assigned
Nov 15, 2012
Last updated
May 11, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP 9225132 FL Primary

Addresses

Primary practice location

3040 N Wickham Rd Ste 10
Wickham Executive Center
Melbourne, FL 32935-2369

Mailing address

3040 N Wickham Rd Ste 10
Wickham Executive Center
Melbourne, FL 32935-2369
Phone (321) 428-4840

Other names 1

  • Julie Lynn Totterdale 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
I20200708002493 FL Practitioner - Nurse Practitioner 0648423574 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medical Associates of Brevard LLCGroup PAC ID 4486558012, 75 clinicians
H2 Rehabilitation Services of Florida LLCGroup PAC ID 3971411851, shared by 10 NPIs, 257 clinicians

Practice addresses (Care Compare)

3040 N Wickham Rd
Suite 10
Melbourne, FL 32935-2369
Phone (321) 428-4840

3680 N Wickham Rd
Suite B
Melbourne, FL 32935-2327
Phone (321) 255-5500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP 9225132FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Associates of Brevard LLC CurrentSince Jun 1, 2020 Accepting new patients

Locations

1305 Hickory St
Melbourne, FL 32901
Phone (321) 255-1500

3040 N Wickham Rd
Ste 10
Melbourne, FL 32935
Phone (321) 428-4840

Interoperability endpoints

  • Direct secure messaging: julieanderson@mab.medentdirect.com

Organizations & group practices 1

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462924800000",
    "number": "1477897692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3040 N WICKHAM RD STE 10",
            "address_2": "WICKHAM EXECUTIVE CENTER",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329352369",
            "telephone_number": "321-428-4840",
            "fax_number": "321-428-4841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3040 N WICKHAM RD STE 10",
            "address_2": "WICKHAM EXECUTIVE CENTER",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329352369",
            "telephone_number": "321-428-4840",
            "fax_number": "321-428-4841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JULIE",
        "middle_name": "TOTTERDALE",
        "name_prefix": "Dr.",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-15",
        "last_updated": "2016-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP 9225132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIE",
            "last_name": "TOTTERDALE",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.