Individual provider Active NPI

Anisa Ann Mead, FNP

  • Family Nurse Practitioner
  • Melbourne, FL
National Provider Identifier
1578326815
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11030926 Issued in FL
Practice address
8045 Spyglass Hill Rd Ste 105
Melbourne, FL 32940-8567
Phone
(321) 610-4960
NPI assigned
Jan 31, 2024
Last updated
Jan 31, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11030926 FL Primary

Addresses

Primary practice location

8045 Spyglass Hill Rd Ste 105
Melbourne, FL 32940-8567

Mailing address

2795 Boston Dr
Titusville, FL 32780-4921
Phone (321) 258-5476

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
I20241024004100 FL Practitioner - Nurse Practitioner 2264965573 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11030926FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Star Internal Medicine and Associates Inc CurrentSince Aug 21, 2024 Accepting new patients

Locations

8045 Spyglass Hill Rd
Ste 105
Viera, FL 32940
Phone (321) 253-1919

Interoperability endpoints

  • Direct secure messaging: anisa.mead.1@14778.direct.athenahealth.com

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, 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": "1706659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1578326815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2795 BOSTON DR",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327804921",
            "telephone_number": "321-258-5476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8045 SPYGLASS HILL RD STE 105",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329408567",
            "telephone_number": "321-610-4960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEAD",
        "first_name": "ANISA",
        "middle_name": "ANN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-31",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11030926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.