Individual provider Active NPI

Ida Jutting Bell, NP

  • Nurse Practitioner
  • Port Orange, FL
National Provider Identifier
1710330733
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
9257624 Issued in FL
Practice address
1175 Dunlawton Ave Ste 102
Port Orange, FL 32127-4741
Phone
(386) 316-8092
NPI assigned
Jul 14, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 200493 ND
Nurse Practitioner 363L00000X 257346 MT
Nurse Practitioner 363L00000X 9257624 FL Primary

Addresses

Primary practice location

1175 Dunlawton Ave Ste 102
Port Orange, FL 32127-4741

Mailing address

2580 Palm Dr
Port Orange, FL 32128-6557
Phone (386) 316-8092

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
I20161017000816 FL Practitioner - Nurse Practitioner 1557659026 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Parks Dermatology Center LLCGroup PAC ID 7315985686, 17 clinicians

Practice addresses (Care Compare)

1175 Dunlawton Ave
Suite 102
Port Orange, FL 32127-4745
Phone 3866779044305

Merit-based Incentive Payment System (MIPS)

Final score
90.62 of 100Reported as group
Quality
100
Promoting interoperability
95
Improvement activities
40
Cost
72.89

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9257624FLMDNurse Practitioner
257346MTMDNurse Practitioner
200493NDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Parks Dermatology Center LLC CurrentSince Apr 10, 2017 Accepting new patients

Locations

400 Lakebridge Plaza Dr
Ormond Beach, FL 32174
Phone (386) 677-9044

1175 Dunlawton Ave
Ste 102
Port Orange, FL 32127
Phone (386) 316-8092

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1468454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1710330733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2580 PALM DR",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321286557",
            "telephone_number": "386-316-8092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 DUNLAWTON AVE STE 102",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321274741",
            "telephone_number": "386-316-8092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELL",
        "first_name": "IDA",
        "middle_name": "JUTTING",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-14",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ND",
            "license": "200493",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MT",
            "license": "257346",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "9257624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orange, FL

Sources for this page

Verify at the official NPI Registry.