Individual provider Active NPI

Rachael L Staton, APRN

  • Nurse Practitioner
  • Largo, FL
National Provider Identifier
1497371173
Registry record updated Jun 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11006388 Issued in FL
Practice address
12347 84TH Way
Largo, FL 33773-2804
Phone
(727) 631-4965
NPI assigned
Jun 18, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2020

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 APRN11006388 FL Primary

Addresses

Primary practice location

12347 84TH Way
Largo, FL 33773-2804

Mailing address

12347 84TH Way
Largo, FL 33773-2804
Phone (727) 631-4965

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
I20200909001551 FL Practitioner - Nurse Practitioner 9032537931 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Polmed PA CurrentSince Jul 7, 2020 Accepting new patients
Pasadena Center for Asthma & Lung Disorders LLC CurrentSince Feb 25, 2021 Accepting new patients
Bayside Emergency Physicians PA CurrentSince Jul 1, 2023 Accepting new patients

Locations

1803 Briar Creek Blvd
Safety Harbor, FL 34695
Phone (727) 216-0505

1615 Pasadena Ave S
Ste 200
South Pasadena, FL 33707
Phone (727) 341-0551

1200 7th Ave N
St Petersburg, FL 33705
Phone (727) 820-7764

5454 Central Ave
Ste A
St Petersburg, FL 33707
Phone (727) 347-5242

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": "1592438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592438400000",
    "number": "1497371173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12347 84TH WAY",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337732804",
            "telephone_number": "727-631-4965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12347 84TH WAY",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337732804",
            "telephone_number": "727-631-4965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STATON",
        "first_name": "RACHAEL",
        "middle_name": "L",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-18",
        "last_updated": "2020-06-18",
        "certification_date": "2020-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11006388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

Verify at the official NPI Registry.