Individual provider Active NPI

Verna Lynn Pedersen Runyan, ARNP

  • Family Nurse Practitioner
  • Weeki Wachee, FL
National Provider Identifier
1740287523
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9221658 Issued in FL
Practice address
4270 Lake in the Woods Dr
Weeki Wachee, FL 34607-2501
Phone
(352) 597-7249
Fax
(352) 597-9523
NPI assigned
Jul 7, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F331179 NY
Family Nurse Practitioner 363LF0000X 9221658 FL Primary

Addresses

Primary practice location

4270 Lake in the Woods Dr
Weeki Wachee, FL 34607-2501

Mailing address

14690 Spring Hill Dr Ste 101
Spring Hill, FL 34609-8102
Phone (352) 799-0046

Other identifiers 2

IdentifierTypeStateIssuer
Y06FUOtherBCBS
003272600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9221658FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Access Healthcare LLC Past Accepting new patients

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": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1740287523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14690 SPRING HILL DR STE 101",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "346098102",
            "telephone_number": "352-799-0046",
            "fax_number": "352-606-2857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4270 LAKE IN THE WOODS DR",
            "city": "WEEKI WACHEE",
            "state": "FL",
            "postal_code": "346072501",
            "telephone_number": "352-597-7249",
            "fax_number": "352-597-9523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSEN RUNYAN",
        "first_name": "VERNA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-07",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F331179",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9221658",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Y06FU",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003272600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Weeki Wachee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.