Tina Louise Macdougall, APRN, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN11020684 Issued in FL

Practice address

2115 SE Lennard Rd
Port St Lucie, FL 34952-4742

Phone

(772) 335-1812

NPI assigned

Aug 25, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/e7eee8ee-10a0-491b-8be6-a8be12c18675/

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.

• Anitha Jagadish M.D, PA

  • Pediatrics Physician
  • Port Saint Lucie, FL
  • NPI 1952538720
  NPD (past)

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

{
    "created_epoch": "1661385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1609595248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 SE LENNARD RD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349524742",
            "telephone_number": "771-335-1812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 SE LENNARD RD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349524742",
            "telephone_number": "772-335-1812"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3855 S US Highway 1",
            "address_purpose": "LOCATION",
            "city": "Fort Pierce",
            "state": "FL",
            "postal_code": "349826621",
            "country_code": "US",
            "telephone_number": "772-462-5646",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACDOUGALL",
        "first_name": "TINA",
        "middle_name": "LOUISE",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-25",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11020684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Tracey Irene Maccia, ITDS
• Omar Agustin Machado Franco
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• Keith Ryan Madonia, PT

• Family Nurse Practitioner in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.