Active NPI
Judith A Flanagan, ARNP
- Psychiatric/Mental Health Nurse Practitioner
- Maitland, FL
National Provider Identifier
1710058060
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- ARNP436302
- Practice address
- 2700 Westhall LN Ste 207
Maitland, FL 32751-7478 - Phone
- (800) 840-2528
- NPI assigned
- Nov 10, 2006
- Last updated
- Aug 15, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | ARNP436302 | FL | Primary |
Addresses
Primary practice location
2700 Westhall LN Ste 207
Maitland, FL 32751-7478
Mailing address
355 Pawnee TRL
Winter Springs, FL 32708-5159
Phone (407) 415-2170
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 007194800 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ARNP436302 | FL | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psychamerica Behavioral Services LLC | Current | Accepting new patients | |
| Adly Thebaud,MD,PA | Psychiatric/Mental Health | Past | Accepting new patients |
Locations
2700 Westhall Ln
Ste 207
Maitland, FL 32751
Phone (407) 636-3532
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Big Bear Behavioral Health
- Community/Behavioral Health Agency
- Orlando, FL
- NPI 1093025702
-
dba Family Psychiatry Services
- Community/Behavioral Health Agency
- Orange City, FL
- NPI 1417018482
Psychiatric/Mental Health
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163116800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565827200000",
"number": "1710058060",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "355 PAWNEE TRL",
"city": "WINTER SPRINGS",
"state": "FL",
"postal_code": "327085159",
"telephone_number": "407-415-2170"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2700 WESTHALL LN STE 207",
"city": "MAITLAND",
"state": "FL",
"postal_code": "327517478",
"telephone_number": "800-840-2528"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLANAGAN",
"first_name": "JUDITH",
"middle_name": "A",
"name_prefix": "Ms.",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-10",
"last_updated": "2019-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "FL",
"license": "ARNP436302",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "007194800",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Maitland, FL
- First Choice Maitland, PLLC (First Choice Urgent Care)
- First Step Therapy LMHC LLC
- Daniel Mason Fisher, ED.S.
- Melanie L Fisher, LCSW
- Thomas A Fisk, M.D.
- Anne Hartman Fleming, OTR
- Brandi Olivia Fliegelman, MSW
- Florida Home Companion
- Florida Hospital Healthcare System, Inc
- Florida Hospital Healthcare System, Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.