Lauren Anne Eggnatz, APRN

Individual provider Active NPI Family Medicine Physician · Orange City, FL

NPI 1497360481 · NPPES record last updated Sep 15, 2020

Key facts

NPI
1497360481
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
11009145 (FL)
Practice address
1725 Monastery Rd
Orange City, FL 32763-6313
Phone
(386) 341-6216
NPI assigned
Sep 15, 2020
Sex
Female
Sole proprietor
Yes

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Opted out of Medicare
Yes, effective Jul 1, 2026 through Jul 1, 2028

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11009145FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ultimate Medical Clinic LLC Current
since Jan 11, 2021
Accepting new patients

Locations

70 Fox Ridge Ct
Ste A
Debary, FL 32713
Phone (386) 668-4411

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 11009145 FL Yes

Addresses

Primary practice location

1725 Monastery Rd
Orange City, FL 32763-6313

Mailing address

1725 Monastery Rd
Orange City, FL 32763-6313
Phone (386) 341-6216

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address lauren.eggnatz@halifax.org

Other providers in Orange City, FL

All providers in Orange City, FL · Family Medicine Physician in Florida

Sources for this page

Verify at the official NPI Registry.