Ian O'Brien, AGNP-BC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

APRN11002144 Issued in FL

Practice address

5757 Plaza Dr
Cypress, CA 90630-5000

Phone

(407) 335-8226

NPI assigned

May 3, 2017

Sex

Male

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

State licenses

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

{
    "created_epoch": "1493769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1700312295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12026 HOFFMAN ST UNIT 101",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "916044726",
            "telephone_number": "321-223-8361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5757 PLAZA DR",
            "city": "CYPRESS",
            "state": "CA",
            "postal_code": "906305000",
            "telephone_number": "407-335-8226"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 Brooker Creek Blvd",
            "address_purpose": "LOCATION",
            "city": "Oldsmar",
            "state": "FL",
            "postal_code": "346772962",
            "country_code": "US",
            "telephone_number": "073-358-2264",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "IAN",
        "credential": "AGNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-03",
        "last_updated": "2021-06-03",
        "certification_date": "2021-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN11002144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Health Nurse Practitioner in Cypress, CA
• Providers in Cypress, CA by specialty
• Adult Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; 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.