Individual provider Active NPI

Kelley Snipes Teixeira, NP-C

  • Adult Health Nurse Practitioner
  • Altamonte Springs, FL
National Provider Identifier
1780015388
Registry record updated Dec 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
ARNP 9221364 Issued in FL
Practice address
817 Douglas Ave
Ste 179
Altamonte Springs, FL 32714-5200
Phone
(407) 331-5050
Fax
(407) 331-5189
NPI assigned
Dec 6, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X ARNP 9221364 FL Primary

Addresses

Primary practice location

817 Douglas Ave
Ste 179
Altamonte Springs, FL 32714-5200

Mailing address

817 Douglas Ave
Ste 179
Altamonte Springs, FL 32714-5200
Phone (407) 331-5050

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
I20140114000825 FL Order and Referring Only - Nurse Practitioner 5991959868

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP 9221364FLMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
A Functional Approach, PA Adult Health Past Accepting new patients
Lawrence Teixeria DC PA PastSince Nov 30, 2012 Accepting new patients

Organizations & group practices 2

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": "1386288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386892800000",
    "number": "1780015388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 DOUGLAS AVE",
            "address_2": "STE 179",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327145200",
            "telephone_number": "407-331-5050",
            "fax_number": "407-331-5189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 DOUGLAS AVE",
            "address_2": "STE 179",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327145200",
            "telephone_number": "407-331-5050",
            "fax_number": "407-331-5189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEIXEIRA",
        "first_name": "KELLEY",
        "middle_name": "SNIPES",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-06",
        "last_updated": "2013-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP 9221364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altamonte Springs, FL

Sources for this page

Verify at the official NPI Registry.