Individual provider Active NPI

Terry L Boutty, ARNP

  • Nurse Practitioner
  • Altamonte Springs, FL
National Provider Identifier
1497087241
Registry record updated Feb 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP2743122 Issued in FL
Practice address
685 Palm Springs Dr
Ste 2a
Altamonte Springs, FL 32701-7853
Phone
(407) 830-5577
Fax
(407) 830-4164
NPI assigned
Feb 4, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP2743122 FL Primary

Addresses

Primary practice location

685 Palm Springs Dr
Ste 2a
Altamonte Springs, FL 32701-7853

Mailing address

601 E Altamonte Dr
Altamonte Springs, FL 32701-4802
Phone (407) 303-2305

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
I20100324000799 FL Practitioner - Nurse Practitioner 2961538350 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Infectious Disease Consultants MD PAGroup PAC ID 3375531320, 30 clinicians

Practice addresses (Care Compare)

685 Palm Springs Dr
Suite 2a
Altamonte Springs, FL 32701-7853
Phone (407) 830-5577

Hospital & facility affiliations

  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Immunology Center PA CurrentSince Jan 1, 2020 Accepting new patients

Locations

685 Palm Springs Dr
Ste 2A
Altamonte Springs, FL 32701
Phone (407) 830-5577

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health 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.

Hospital & facility affiliations 2

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": "1265241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551312000000",
    "number": "1497087241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 E ALTAMONTE DR",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327014802",
            "telephone_number": "407-303-2305",
            "fax_number": "866-445-1446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "685 PALM SPRINGS DR",
            "address_2": "STE 2A",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327017853",
            "telephone_number": "407-830-5577",
            "fax_number": "407-830-4164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUTTY",
        "first_name": "TERRY",
        "middle_name": "L",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-04",
        "last_updated": "2019-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP2743122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altamonte Springs, FL

Sources for this page

Verify at the official NPI Registry.