Individual provider Active NPI

Ipatia D Magnus, PHD, DNP, FPMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Hudson, FL
National Provider Identifier
1619989076
Registry record updated Jun 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1961592 Issued in FL
Practice address
13910 Fivay Rd Ste 8
Hudson, FL 34667
Phone
(727) 858-2007
Fax
(727) 862-7163
NPI assigned
Aug 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1961592 FL Primary

Addresses

Primary practice location

13910 Fivay Rd Ste 8
Hudson, FL 34667

Mailing address

13910 Fivay Rd Ste 8
Hudson, FL 34667-7130
Phone (727) 858-2007

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
I20100422000442 FL Practitioner - Nurse Practitioner 1557498599 Practice locations: Hudson, FL

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

13910 Fivay Rd
Suite 8
Hudson, FL 34667-7130
Phone (727) 863-0063

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1961592FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
John P McDonough III Psychiatric/Mental Health CurrentSince Mar 5, 2013 Accepting new patients
GPS II PastSince Mar 5, 2013 Accepting new patients

Organizations & group practices 2

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": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1619989076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13910 FIVAY RD STE 8",
            "city": "HUDSON",
            "state": "FL",
            "postal_code": "346677130",
            "telephone_number": "727-858-2007",
            "fax_number": "727-053-1696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13910 FIVAY RD STE 8",
            "city": "HUDSON",
            "state": "FL",
            "postal_code": "34667",
            "telephone_number": "727-858-2007",
            "fax_number": "727-862-7163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGNUS",
        "first_name": "IPATIA",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "PHD, DNP, FPMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-13",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "1961592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, FL

Sources for this page

Verify at the official NPI Registry.