Individual provider Active NPI

Nadia Laverne Etienne, APRN

  • Family Nurse Practitioner
  • Zephyrhills, FL
National Provider Identifier
1619408341
Registry record updated Jun 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN9167575 Issued in FL
Practice address
38135 Market Square Dr
Zephyrhills, FL 33542-7505
Phone
(813) 778-0425
Fax
(813) 377-1683
NPI assigned
Mar 24, 2017
Last updated
Jun 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X ARNP9167575 FL
Family Nurse Practitioner 363LF0000X APRN9167575 FL Primary
Registered Nurse 163W00000X RN9167575 FL

Addresses

Primary practice location

38135 Market Square Dr
Zephyrhills, FL 33542-7505

Mailing address

38135 Market SQ
Zephyrhills, FL 33542-7539
Phone (813) 780-8692

Other practice location 1

17733 Long Ridge Rd
Tampa, FL 33647-2524
Phone (813) 373-4034

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
I20180719001399 FL Practitioner - Nurse Practitioner 2769739994 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Florida College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ohi West Medical Group II LLCGroup PAC ID 0648631192, 407 clinicians

Practice addresses (Care Compare)

38135 Market Square Dr
Suite 102
Zephyrhills, FL 33542-7505
Phone (813) 782-8829

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN9167575FLMDRegistered Nurse
APRN9167575FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ohi West Medical Group II LLC CurrentSince May 1, 2024 Accepting new patients
Florida Medical Clinic, LLC CurrentSince Jul 9, 2018 Accepting new patients
Florida Medical Clinic LLC CurrentSince Jul 9, 2018 Accepting new patients
Ohi West Medical Group II LLC CurrentSince May 1, 2024 Accepting new patients

Locations

38051 Market Square Dr
Zephyrhills, FL 33542
Phone (813) 779-2057

38135 Market Square Dr
Zephyrhills, FL 33542
Phone (352) 567-0188

38135 Market Square Dr
Ste 101
Zephyrhills, FL 33542
Phone (813) 788-7651

38135 Market Square Dr
Ste 102
Zephyrhills, FL 33542
Phone (813) 782-8829

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1490313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1619408341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38135 MARKET SQ",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335427539",
            "telephone_number": "813-780-8692",
            "fax_number": "813-355-5037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38135 MARKET SQUARE DR",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335427505",
            "telephone_number": "813-778-0425",
            "fax_number": "813-377-1683"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17733 Long Ridge Rd",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336472524",
            "country_code": "US",
            "telephone_number": "813-373-4034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ETIENNE",
        "first_name": "NADIA",
        "middle_name": "LAVERNE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-24",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "ARNP9167575",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9167575",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9167575",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Zephyrhills, FL

Sources for this page

Verify at the official NPI Registry.