Individual provider Active NPI

Lindsey K Busch, ARNP

  • Family Nurse Practitioner
  • South Daytona, FL
National Provider Identifier
1710470299
Registry record updated Dec 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9318209 Issued in FL
Practice address
711 Beville Rd
South Daytona, FL 32119-1823
Phone
(386) 760-8116
Fax
(888) 486-1253
NPI assigned
Jun 11, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2021

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 9318209 FL Primary

Addresses

Primary practice location

711 Beville Rd
South Daytona, FL 32119-1823

Mailing address

6101 Blue Lagoon Dr Ste 400
Miami, FL 33126-2051
Phone (305) 500-2000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lindsey.busch@conviva.eclinicaldirectplus.com Direct

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
I20180809006075 FL Practitioner - Nurse Practitioner 8820346679 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9318209FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Conviva Medical Center Management LLC CurrentSince Jan 1, 2021 Accepting new patients
Metcare of Florida, Inc Past Accepting new patients

Locations

731 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 257-1626

5238 Norwood Ave
#16
Jacksonville, FL 32208
Phone (904) 265-2050

6101 Blue Lagoon Dr
Ste 400
Miami, FL 33126
Phone (305) 500-2114

6101 Waterford District Dr
Ste 200
Miami, FL 33126
Phone (407) 533-6836

1700 SE Hillmoor Dr
Ste 500
Port St Lucie, FL 34952
Phone (772) 335-3200

711 Beville Rd
South Daytona, FL 32119
Phone (386) 760-8116

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.

NPI Registry JSON

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

{
    "created_epoch": "1528675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638662400000",
    "number": "1710470299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 BLUE LAGOON DR STE 400",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331262051",
            "telephone_number": "305-500-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 BEVILLE RD",
            "city": "SOUTH DAYTONA",
            "state": "FL",
            "postal_code": "321191823",
            "telephone_number": "386-760-8116",
            "fax_number": "888-486-1253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSCH",
        "first_name": "LINDSEY",
        "middle_name": "K",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-11",
        "last_updated": "2021-12-05",
        "certification_date": "2021-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9318209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lindsey.busch@conviva.eclinicaldirectplus.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "711 Beville Rd",
            "city": "South Daytona",
            "state": "FL",
            "country_code": "US",
            "postal_code": "321191823",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in South Daytona, FL

Sources for this page

Verify at the official NPI Registry.