Individual provider Active NPI

Pamela S Gould, ARNP

  • Pediatric Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1528090974
Registry record updated Feb 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
ARNP2161412 Issued in FL
Practice address
92 W Miller St
Orlando, FL 32806-2032
Phone
(321) 841-8588
Fax
(321) 841-8560
NPI assigned
Jul 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X ARNP2161412 FL Primary

Addresses

Primary practice location

92 W Miller St
Orlando, FL 32806-2032

Mailing address

92 W Miller St
Orlando, FL 32806-2032
Phone (321) 841-8588

Other practice location 1

92 W Miller St
Orlando, FL 32806-2032
Phone (321) 841-8588

Other identifiers 1

IdentifierTypeStateIssuer
304532300MedicaidFL

Other names 1

  • Pamela Sue Russell Other 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
I20110712000750 FL Practitioner - Nurse Practitioner 4082882329 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc CurrentSince Feb 1, 2018 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince May 11, 2011 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Feb 1, 2018 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince May 11, 2011 Accepting new patients
Orlando Health, Inc. Current Accepting new patients

Locations

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

92 W Miller St
Orlando, FL 32806
Phone (321) 841-4607

Interoperability endpoints

  • Direct secure messaging: pgould36343@orlandohealth.medalliesdirect.net

Organizations & group practices 5

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519430400000",
    "number": "1528090974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 W MILLER ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062032",
            "telephone_number": "321-841-8588",
            "fax_number": "321-841-8560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 W MILLER ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062032",
            "telephone_number": "321-841-8588",
            "fax_number": "321-841-8560"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "92 W Miller St",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328062032",
            "country_code": "US",
            "telephone_number": "321-841-8588",
            "fax_number": "321-841-8588",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOULD",
        "first_name": "PAMELA",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2018-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "ARNP2161412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "304532300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAMELA",
            "last_name": "RUSSELL",
            "middle_name": "SUE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.