Individual provider Active NPI

Ilka Fawn Sephus, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1629789177
Registry record updated Jan 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN11020697 Issued in FL
Practice address
10967 Lake Underhill Rd Ste 113
Orlando, FL 32825-4434
Phone
(833) 769-3524
NPI assigned
Dec 6, 2022
Last updated
Jan 5, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11020697 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11020697 FL Primary
Registered Nurse 163W00000X 9367205 FL

Addresses

Primary practice location

10967 Lake Underhill Rd Ste 113
Orlando, FL 32825-4434

Mailing address

10967 Lake Underhill Rd Ste 113
Orlando, FL 32825-4434
Phone (833) 769-3524

Other practice location 1

18324 Bellezza Dr
Orlando, FL 32820-1451
Phone (301) 523-6414

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
I20250218003601 FL Practitioner - Nurse Practitioner 9739609959 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Personal Recovery Network LLCGroup PAC ID 5092611384, 612 clinicians

Practice addresses (Care Compare)

10967 Lake Underhill Rd
Suite 113
Orlando, FL 32825-4434
Phone (407) 537-9451

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9367205FLMDRegistered Nurse
11020697FLMDFamily Nurse Practitioner
APRN11020697FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Personal Recovery Network LLC CurrentSince Mar 1, 2025 Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

260 Lookout Pl
Ste 202
Maitland, FL 32751
Phone (407) 537-9450

10967 Lake Underhill Rd
Ste 113
Orlando, FL 32825
Phone (407) 537-9451

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.ilkasephus@141363.advancedmd-direct.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1670284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767571200000",
    "number": "1629789177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10967 LAKE UNDERHILL RD STE 113",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328254434",
            "telephone_number": "833-769-3524",
            "fax_number": "407-412-9170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10967 LAKE UNDERHILL RD STE 113",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328254434",
            "telephone_number": "833-769-3524"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18324 Bellezza Dr",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328201451",
            "country_code": "US",
            "telephone_number": "301-523-6414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEPHUS",
        "first_name": "ILKA",
        "middle_name": "FAWN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-06",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11020697",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11020697",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9367205",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.