Active NPI
Mayelin Gomez, ARNP-C
- Adult Health Nurse Practitioner
- Fort Myers, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- ARNP3049922
- Practice address
- 16410 Healthpark Commons Dr
Fort Myers, FL 33908 - Phone
- (239) 343-6202
- Fax
- (239) 437-8537
- NPI assigned
- Feb 22, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | ARNP3049922 | FL | Primary |
Addresses
Primary practice location
16410 Healthpark Commons Dr
Fort Myers, FL 33908
Mailing address
PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-6202
Other practice location 1
1120 15th St
Augusta, GA 30912-1051
Phone (706) 721-8623
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 103204700 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA, FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ARNP3049922 | FL | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Au Medical Center, Inc. | Current | Accepting new patients | |
| Au Medical Associates Inc | Current | Accepting new patients | |
| Au Medical Associates Inc | Current | Accepting new patients | |
| Au Medical Center, Inc | Current | Accepting new patients | |
| Community Care Health Network LLC | Current | Accepting new patients |
Locations
9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883
2202 N West Shore Blvd
Ste 200
Tampa, FL 33607
Phone (317) 452-4352
2202 N West Shore Blvd
Tampa, FL 33607
Phone (813) 416-4680
1000 Parkwood Cir SE
Ste 900
Atlanta, GA 30339
Phone (216) 393-8684
1120 15th St
Ste BI1056
Augusta, GA 30912
Phone (706) 721-2785
1120 15th St
Augusta, GA 30912
Phone (706) 721-3873
Organizations & group practices 5
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.
-
- Multi-Specialty Clinic/Center
- Augusta, GA
- NPI 1841230620
-
- General Acute Care Hospital
- Augusta, GA
- NPI 1437135902
-
dba Matrix Medical Network
- Nurse Practitioner
- Nashville, TN
- NPI 1619368842
FL, GA
-
dba Augusta University Health West Wheeler
- Durable Medical Equipment & Medical Supplies
- Augusta, GA
- NPI 1114574126
-
dba AU Medical Center Employee Pharmacy
- Community/Retail Pharmacy
- Augusta, GA
- NPI 1487901476
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599091200000",
"number": "1770618860",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2147",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339022147",
"telephone_number": "239-343-6202",
"fax_number": "239-437-8537"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16410 HEALTHPARK COMMONS DR",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "33908",
"telephone_number": "239-343-6202",
"fax_number": "239-437-8537"
}
],
"practiceLocations": [
{
"address_1": "1120 15th St",
"address_purpose": "LOCATION",
"city": "Augusta",
"state": "GA",
"postal_code": "309121051",
"country_code": "US",
"telephone_number": "706-721-8623",
"fax_number": "706-721-1459",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GOMEZ",
"first_name": "MAYELIN",
"name_prefix": "Ms.",
"credential": "ARNP-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-22",
"last_updated": "2020-09-03",
"certification_date": "2020-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "FL",
"license": "ARNP3049922",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "103204700",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.