Individual provider Active NPI

Roodina Celius Joseph

  • Family Nurse Practitioner
  • Port Saint Lucie, FL
National Provider Identifier
1760249551
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1101564 Issued in FL
Practice address
1032 SW McCoy Ave
Port Saint Lucie, FL 34953-3613
Phone
(561) 303-5609
NPI assigned
Feb 28, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2024

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 1101564 FL Primary

Addresses

Primary practice location

1032 SW McCoy Ave
Port Saint Lucie, FL 34953-3613

Mailing address

1032 SW McCoy Ave
Port Saint Lucie, FL 34953-3613
Phone (561) 303-5609

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1101564FLMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1709078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709078400000",
    "number": "1760249551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1032 SW MCCOY AVE",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349533613",
            "telephone_number": "561-303-5609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1032 SW MCCOY AVE",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349533613",
            "telephone_number": "561-303-5609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CELIUS JOSEPH",
        "first_name": "ROODINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-28",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "1101564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2024; 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.