Active NPI
Mishela Gevorkyan
- Psychiatric/Mental Health Nurse Practitioner
- Fort Walton Beach, FL
National Provider Identifier
1588246714
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 11011131
- Practice address
- 1046 Mar Walt Dr # 200
Fort Walton Beach, FL 32547-6645 - Phone
- (850) 243-2229
- NPI assigned
- Apr 27, 2021
- Last updated
- Feb 24, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 11011131 | FL | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 11011131 | FL | Primary |
Addresses
Primary practice location
1046 Mar Walt Dr # 200
Fort Walton Beach, FL 32547-6645
Mailing address
92 SW 3Rd St
Miami, FL 33130-2998
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | N/A |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11011131 | FL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rivia Medical PLLC | Family | Past | Accepting new patients |
Interoperability endpoints
- mishela.gevorkyan.3@23211.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": "1619481600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740355200000",
"number": "1588246714",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "92 SW 3RD ST",
"city": "MIAMI",
"state": "FL",
"postal_code": "331302998"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1046 MAR WALT DR # 200",
"city": "FORT WALTON BEACH",
"state": "FL",
"postal_code": "325476645",
"telephone_number": "850-243-2229"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEVORKYAN",
"first_name": "MISHELA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-27",
"last_updated": "2025-02-24",
"certification_date": "2025-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "FL",
"license": "11011131",
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "FL",
"license": "11011131",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "N/A",
"affiliation": "N",
"address_1": "1180 SW 2nd Ave",
"city": "Miami",
"state": "FL",
"country_code": "US",
"postal_code": "331304012",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Fort Walton Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.