Nurse Practitioner Group LLC

Primary specialty

ContractorTaxonomy code 171W00000X

License

ARNP9224482 Issued in FL

Legal business name

NURSE PRACTITIONER GROUP LLC

Practice address

12380 NW 9TH St
Plantation, FL 33325-1305

Phone

(256) 508-9034

NPI assigned

Jan 23, 2017

Organization subpart

No

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

Authorized official

Name

Stacey Santiago

Title

Owner

Phone

(256) 508-9034

Specialties & licenses 2

Addresses

Other names 2

• My Mobile Primary Health Care, LLC Other name
• The Nurse Practitioner Group LLC Other name

Medicare fee-for-service enrollment

Enrolled in MD, DC, FL, NC, PA, TN, VA, CA, KS, MI, CO, MA, AZ, OH, MO, TX, AL17 enrollments

Enrollment records 17

Locations

Practitioners 31

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Taren-Rae Bryan

  • Family Nurse Practitioner
  • Miramar, FL
  • NPI 1255999496

  FL

  Medicare reassignment NPD
• Parvin Deidri Daneshvar, DNP, APRN, FNP-C

  • Nurse Practitioner
  • Merritt Island, FL
  • NPI 1356983092

  FL

  Medicare reassignment NPD
• Leslie Kapp-Jones, APRN

  • Family Nurse Practitioner
  • Tampa, FL
  • NPI 1003464074

  FL

  Medicare reassignment NPD
• Melissa Marballie, FNP

  • Family Nurse Practitioner
  • Weston, FL
  • NPI 1881863363

  FL

  Medicare reassignment NPD
• Latasha Wiley

  • Family Nurse Practitioner
  • Jacksonville, FL
  • NPI 1821628207

  FL

  Medicare reassignment NPD
• Latasha Nicole Baxter, CRNP

  • Adult Health Nurse Practitioner
  • Silver Spring, MD
  • NPI 1497778690

  DC, MD

  Medicare reassignment NPD
• Myrlande Blanc, RN

  • Nurse Practitioner
  • Framingham, MA
  • NPI 1194442970

  MA

  Medicare reassignment NPD
• Sandra Yvonne Blatz, NP

  • Adult Health Clinical Nurse Specialist
  • Allentown, PA
  • NPI 1134563539

  PA

  Medicare reassignment NPD
• Valerie M Brown, WHNP-BC

  • Women's Health Nurse Practitioner
  • Langley Afb, VA
  • NPI 1639636780

  VA

  Medicare reassignment NPD
• Emily Allison Carey

  • Family Nurse Practitioner
  • Columbus, OH
  • NPI 1720315625

  OH

  Medicare reassignment NPD
• Mary Christina Carter, APRN

  • Family Nurse Practitioner
  • Crossville, TN
  • NPI 1700369006

  TN

  Medicare reassignment NPD
• Kelly Clark, APRN-CNP

  • Gerontology Nurse Practitioner
  • Cincinnati, OH
  • NPI 1902579238

  OH

  Medicare reassignment NPD

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

{
    "created_epoch": "1485129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595289600000",
    "number": "1780121277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12380 NW 9TH ST",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333251305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12380 NW 9TH ST",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333251305",
            "telephone_number": "256-508-9034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NURSE PRACTITIONER GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-23",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A",
        "authorized_official_last_name": "SANTIAGO",
        "authorized_official_first_name": "STACEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-508-9034"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Contractor",
            "state": "FL",
            "license": "ARNP9224482",
            "primary": true
        },
        {
            "code": "363LX0106X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Occupational Health",
            "state": "MD",
            "license": "R185090",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "My Mobile Primary Health Care, LLC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "My Mobile Primary Health Care, LLC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "The Nurse Practitioner Group LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Sylvia Dolores Nunez Otero, LMT
• Dagmar E Nunez, PSY D
• Gabriela Nunez
• Jose Andres Nunez
• Nurclex Medical Solutions LLC
• Nutrition in Motion
• Amanda Nwaopara, MD, MSC GENOMIC MED
• Katherine M O'Flynn, M.D.
• Kevin O'Keefe, PH.D.
• Mara O'Mara

• All providers in Plantation, FL
• Contractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.