Organization Active NPI

Paradise Family Practice LLC

  • Family Nurse Practitioner
  • Port Orange, FL
National Provider Identifier
1609662337
Registry record updated Mar 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
PARADISE FAMILY PRACTICE LLC
Practice address
1402 Dunlawton Ave
Port Orange, FL 32127-2917
Phone
(386) 561-9026
Fax
(828) 800-9933
NPI assigned
Apr 18, 2025
Last updated
Mar 24, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2026

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

Authorized official

Name
Cassie HarrisonNPI 1710629852
Title
Owner
Phone
(386) 405-7375

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X Primary

Addresses

Primary practice location

1402 Dunlawton Ave
Port Orange, FL 32127-2917

Mailing address

5327 Plantation Home Way
Port Orange, FL 32128-7528
Phone (386) 278-0183

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250429002461 FL Part B Supplier - Clinic/Group Practice 5799201125 Receives reassigned benefits from 1 practitioner
Practice locations: Port Orange, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1744934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774310400000",
    "number": "1609662337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5327 PLANTATION HOME WAY",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321287528",
            "telephone_number": "386-278-0183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 DUNLAWTON AVE",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321272917",
            "telephone_number": "386-561-9026",
            "fax_number": "828-800-9933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARADISE FAMILY PRACTICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-18",
        "last_updated": "2026-03-24",
        "certification_date": "2026-03-24",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "CASSIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-405-7375"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orange, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.