Individual provider Active NPI

Luanne Gravano Sadowsky, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Lakeland, FL
National Provider Identifier
1508832312
Registry record updated Dec 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN9217373 Issued in FL
Practice address
1835 Gilmore Ave
Lakeland, FL 33805-3017
Phone
(863) 519-0575
Fax
(863) 582-9251
NPI assigned
Feb 23, 2006
Last updated
Dec 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2024

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 APRN9217373 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN9217373 FL Primary

Addresses

Primary practice location

1835 Gilmore Ave
Lakeland, FL 33805-3017

Mailing address

PO Box 1559
Bartow, FL 33831-1559
Phone (863) 519-0575

Other practice location 1

1255 Golfview Ave
Bartow, FL 33830-6736
Phone (863) 519-0575 ext. 6494

Other identifiers 2

IdentifierTypeStateIssuer
Y080JOtherFLBLUE CROSS BLUE SHIELD
125115500MedicaidFL

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
I20041207000717 FL Practitioner - Nurse Practitioner 1456317882 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN9217373FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Peace River Center for Personal Development Inc CurrentSince Apr 17, 2022 Accepting new patients
Lakeland Regional Medical Center, Inc. Past Accepting new patients
Valdosta Psychiatric Associates, LLC Past Accepting new patients
Huntingdon Healthcare Inc PastSince Jun 1, 2006 Accepting new patients
Lakeland Regional Health Systems, Inc. PastSince Jan 2, 2018 Accepting new patients
Lifestream Behavioral Center Inc Past Accepting new patients

Locations

1825 Gilmore Ave
Lakeland, FL 33805
Phone (863) 248-3300

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735171200000",
    "number": "1508832312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1559",
            "city": "BARTOW",
            "state": "FL",
            "postal_code": "338311559",
            "telephone_number": "863-519-0575",
            "fax_number": "866-582-9251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835 GILMORE AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338053017",
            "telephone_number": "863-519-0575",
            "fax_number": "863-582-9251"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1255 Golfview Ave",
            "address_purpose": "LOCATION",
            "city": "Bartow",
            "state": "FL",
            "postal_code": "338306736",
            "country_code": "US",
            "telephone_number": "863-519-0575 x6494",
            "fax_number": "863-582-9251",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SADOWSKY",
        "first_name": "LUANNE",
        "middle_name": "GRAVANO",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-23",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "APRN9217373",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN9217373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "Y080J",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "125115500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.