Individual provider Active NPI

Regina Shanese Scott, ARNP-BC

  • Family Nurse Practitioner
  • Windermere, FL
National Provider Identifier
1740527852
Registry record updated May 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN9251571 Issued in FL
Practice address
11600 Lakeside Village LN
Windermere, FL 34786-7024
Phone
(407) 876-2273
Fax
(407) 347-3950
NPI assigned
Jan 9, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2022

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 APRN9251571 FL Primary

Addresses

Primary practice location

11600 Lakeside Village LN
Windermere, FL 34786-7024

Mailing address

3300 S Fiske Blvd
Rockledge, FL 32955-4306
Phone (407) 876-2273

Other identifiers 1

IdentifierTypeStateIssuer
O3800OtherFLFL HF MA

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
I20130227000326 FL Practitioner - Nurse Practitioner 2769637511 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Health First Privia Medical GroupGroup PAC ID 3173965993, 247 clinicians

Practice addresses (Care Compare)

11600 Lakeside Village LN
Windermere, FL 34786-7024
Phone (770) 312-5226

140 6TH Ave
Indialantic, FL 32903-3204
Phone (321) 312-3501

17323 Pagonia Rd
Clermont, FL 34711-5997
Phone (352) 995-8710

989 Sebastian Blvd
Unit 3
Sebastian, FL 32958-4879
Phone (727) 617-1777

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group Florida, LLC CurrentSince Jan 1, 2025 Accepting new patients
West Orange Nephrology LLC CurrentSince Feb 11, 2013 Accepting new patients
Onyx Medical & Wellness Center LLC PastSince Jan 1, 2025 Accepting new patients

Locations

17323 Pagonia Rd
Clermont, FL 34711
Phone (352) 995-8710

140 6th Ave
Indialantic, FL 32903
Phone (321) 312-3501

3300 S Fiske Blvd
Rockledge, FL 32955
Phone (321) 434-1771

989 Sebastian Blvd
Unit 3
Sebastian, FL 32958
Phone (727) 617-1777

11600 Lakeside Village Ln
Windermere, FL 34786
Phone (407) 876-2273

301 S West Crown Point Rd
Ste 120
Winter Garden, FL 34787

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BCFJCA
  • Direct secure messaging: regina.scott.1@8042.direct.athenahealth.com

Organizations & group practices 3

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": "1357689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651536000000",
    "number": "1740527852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 S FISKE BLVD",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329554306",
            "telephone_number": "407-876-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11600 LAKESIDE VILLAGE LN",
            "city": "WINDERMERE",
            "state": "FL",
            "postal_code": "347867024",
            "telephone_number": "407-876-2273",
            "fax_number": "407-347-3950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "REGINA",
        "middle_name": "SHANESE",
        "name_prefix": "Mrs.",
        "credential": "ARNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-09",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9251571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL HF MA",
            "identifier": "O3800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Windermere, FL

Sources for this page

Verify at the official NPI Registry.