Michael Nathan Peddycoart, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

APRN9227732 Issued in FL

Practice address

7406 Fullerton St
Jacksonville, FL 32256-3552

Phone

(863) 529-6259

NPI assigned

Aug 28, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Cogent Healthcare of Jacksonville, LLC

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1124252333
  Medicare reassignment NPD
• Longevity Clinical LTC Associates of Florida PLLC

  • Primary Care Nurse Practitioner
  • Lauderhill, FL
  • NPI 1639743750
  Medicare reassignment NPD
• Sound Physicians of Florida IV, LLC

  • Internal Medicine Physician
  • Palm Coast, FL
  • NPI 1740633635
  Medicare reassignment NPD
• Cogent Healthcare of Jacksonville, LLC

  • Internal Medicine Physician
  • Port Orange, FL
  • NPI 1861150625
  NPD
• Sound Physicians of Florida IV, LLC

  • Internal Medicine Physician
  • Tampa, FL
  • NPI 1235712415
  NPD

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

{
    "created_epoch": "1440720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593648000000",
    "number": "1770950420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7406 FULLERTON ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322563552",
            "telephone_number": "863-529-6259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7406 FULLERTON ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322563552",
            "telephone_number": "863-529-6259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDDYCOART",
        "first_name": "MICHAEL",
        "middle_name": "NATHAN",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-28",
        "last_updated": "2020-07-02",
        "certification_date": "2020-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN9227732",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL APRN LICENSE",
            "identifier": "APRN9227732",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL RN LICENSE",
            "identifier": "RN9227732",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kurt Pechnick, MPT
• Christina Peck
• Lee H Peck, MD
• Robin Lee Peck
• Peculiar Healthcare LLC.
• Lauren Elizabeth Pedersen
• Nicole Marie Pedersen, FNP
• Stephen Mark Pederson
• Pediatric Associates at Argyle PA
• Pediatric Associates at Argyle PA

• Adult Health Nurse Practitioner in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Adult Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 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.

Verify at the official NPI Registry.