Individual provider Active NPI

Taylor Greene, APRN-FNP

  • Family Nurse Practitioner
  • Titusville, FL
National Provider Identifier
1780446617
Registry record updated Apr 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11031825 Issued in FL
Practice address
3300 Dairy Rd
Titusville, FL 32796-1512
Phone
(321) 269-6530
Fax
(321) 269-2334
NPI assigned
Jan 25, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 9512246 FL
Family Nurse Practitioner 363LF0000X 11031825 FL Primary

Addresses

Primary practice location

3300 Dairy Rd
Titusville, FL 32796-1512

Mailing address

951 N Washington Ave
Titusville, FL 32796-2163
Phone (321) 200-6910

Other practice location 1

951 N Washington Ave
Titusville, FL 32796-2163
Phone (321) 268-6111

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
I20240506001333 FL Practitioner - Nurse Practitioner 9537509633 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Indian River Medical Office PAGroup PAC ID 2668527201, 3 clinicians

Practice addresses (Care Compare)

3300 Dairy Rd
Titusville, FL 32796-1512
Phone (321) 269-6530

Hospital & facility affiliations

  • Parrish Home Health Home health agency, Titusville, FL, CCN 107488
  • Health First Home Care Home health agency, Melbourne, FL, CCN 107233
  • Parrish Medical Center Hospital, Titusville, FL, CCN 100028

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9512246FLMDRegistered Nurse
11031825FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Indian River Medical Office PA CurrentSince Mar 23, 2024 Accepting new patients

Locations

3300 Dairy Rd
Titusville, FL 32796
Phone (321) 267-6687

951 N Washington Ave
Titusville, FL 32796
Phone (302) 325-5511

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BFFICA

Organizations & group practices 1

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1706140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713139200000",
    "number": "1780446617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "951 N WASHINGTON AVE",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327962163",
            "telephone_number": "321-200-6910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 DAIRY RD",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327961512",
            "telephone_number": "321-269-6530",
            "fax_number": "321-269-2334"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "951 N Washington Ave",
            "address_purpose": "LOCATION",
            "city": "Titusville",
            "state": "FL",
            "postal_code": "327962163",
            "country_code": "US",
            "telephone_number": "321-268-6111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREENE",
        "first_name": "TAYLOR",
        "credential": "APRN-FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-25",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9512246",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11031825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Titusville, FL

Sources for this page

Verify at the official NPI Registry.