Individual provider Active NPI

Hyacinth Fay Addison

  • Primary Care Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1780116012
Registry record updated Mar 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
ARNP 9199382 Issued in FL
Practice address
13944 Broadwing Dr
Orlando, FL 32837-8122
Phone
(407) 201-9051
Fax
(407) 855-6819
NPI assigned
Mar 28, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X ARNP 9199382 FL Primary

Addresses

Primary practice location

13944 Broadwing Dr
Orlando, FL 32837-8122

Mailing address

13944 Broadwing Dr
Orlando, FL 32837-8122
Phone (407) 201-9051

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP 9199382FLMDPrimary Care Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1490659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490659200000",
    "number": "1780116012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13944 BROADWING DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328378122",
            "telephone_number": "407-201-9051",
            "fax_number": "407-855-6819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13944 BROADWING DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328378122",
            "telephone_number": "407-201-9051",
            "fax_number": "407-855-6819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADDISON",
        "first_name": "HYACINTH",
        "middle_name": "FAY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-28",
        "last_updated": "2017-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "ARNP 9199382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2017; 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.