Individual provider Active NPI

Elena Renee Hale, ARNP

  • Family Nurse Practitioner
  • Port Charlotte, FL
National Provider Identifier
1700420601
Registry record updated Dec 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11004182 Issued in FL
Practice address
693 Hartford Dr NW
Port Charlotte, FL 33952-6440
Phone
(757) 880-7784
NPI assigned
Nov 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11004182 FL Primary

Addresses

Primary practice location

693 Hartford Dr NW
Port Charlotte, FL 33952-6440

Mailing address

693 Hartford Dr NW
Port Charlotte, FL 33952-6440
Phone (941) 740-6100

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
I20200304000661 FL Practitioner - Nurse Practitioner 2769819739 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

26455 Rampart Blvd
Punta Gorda, FL 33983-6211
Phone (941) 740-6100

693 Hartford Dr NW
Port Charlotte, FL 33952-6440

Hospital & facility affiliations

  • Assisted Home Health Inc Home health agency, Punta Gorda, FL, CCN 683178
  • Amedisys Home Health Home health agency, Port Charlotte, FL, CCN 108270
  • Sunrise Home Health & Supplies LLC Home health agency, Port Charlotte, FL, CCN 107716

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11004182FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care 2 You LLC CurrentSince Dec 29, 2020 Accepting new patients
Delta Medical Associates, LLC CurrentSince Jul 25, 2022 Accepting new patients

Locations

1600 Center Rd
Venice, FL 34292
Phone (941) 217-7193

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.

Hospital & facility affiliations 3

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": "1572825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607385600000",
    "number": "1700420601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "693 HARTFORD DR NW",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339526440",
            "telephone_number": "941-740-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "693 HARTFORD DR NW",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339526440",
            "telephone_number": "757-880-7784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALE",
        "first_name": "ELENA",
        "middle_name": "RENEE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-04",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11004182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

Verify at the official NPI Registry.