Individual provider Active NPI

Elizabeth P Severance, ARNP

  • Pediatric Nurse Practitioner
  • Gainesville, FL
National Provider Identifier
1598841967
Registry record updated Jul 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
APRN2718212 Issued in FL
Practice address
4197 NW 86TH Ter FL 3
Gainesville, FL 32606-9278
Phone
(352) 265-5404
NPI assigned
Oct 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X APRN2718212 FL Primary
Nurse Practitioner 363L00000X ARNP2718212 FL

Addresses

Primary practice location

4197 NW 86TH Ter FL 3
Gainesville, FL 32606-9278

Mailing address

PO Box 100234
Gainesville, FL 32610-0234
Phone (352) 392-3641

Other identifiers 1

IdentifierTypeStateIssuer
014234300MedicaidFL

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
I20211018000728 FL Practitioner - Nurse Practitioner 2062810393 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP2718212FLMDNurse Practitioner
APRN2718212FLMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc CurrentSince Oct 12, 2021 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Oct 12, 2021 Accepting new patients
Alliance Pediatrics PA Pediatrics Past 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

4197 NW 86th Ter
Fl 3
Gainesville, FL 32606
Phone (352) 265-5404

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": "1161993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722038400000",
    "number": "1598841967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100234",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100234",
            "telephone_number": "352-392-3641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4197 NW 86TH TER FL 3",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326069278",
            "telephone_number": "352-265-5404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEVERANCE",
        "first_name": "ELIZABETH",
        "middle_name": "P",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-28",
        "last_updated": "2024-07-27",
        "certification_date": "2024-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "APRN2718212",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP2718212",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014234300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.