Individual provider Active NPI

Nathaly Arredondo, ARNP

  • Nurse Practitioner
  • Lakeland, FL
National Provider Identifier
1790115087
Registry record updated Nov 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN9242686 Issued in FL
Practice address
1324 Lakeland Hills Blvd
Lakeland, FL 33805-4543
Phone
(863) 687-1359
NPI assigned
Nov 22, 2013
Last updated
Nov 22, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN9242686 FL Primary
Primary Care Nurse Practitioner 363LP2300X RN9242686 FL

Addresses

Primary practice location

1324 Lakeland Hills Blvd
Lakeland, FL 33805-4543

Mailing address

1825 Pawnee TRL
Lakeland, FL 33803-2171
Phone (863) 682-5538

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
I20140509001347 FL Practitioner - Nurse Practitioner 1456584838 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
98
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN9242686FLMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians Inc CurrentSince Aug 1, 2022 Accepting new patients
Emergency Physicians Inc CurrentSince Aug 1, 2022 Accepting new patients
Florida Em-I Medical Services PA Past Accepting new patients

Locations

1250 S 18th St
Ste 202
Fernandina Beach, FL 32034
Phone (904) 202-2000

1747 Baptist Clay Dr
Ste 250
Fleming Isle, FL 32003
Phone (904) 516-1000

1324 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 687-1132

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1385078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385078400000",
    "number": "1790115087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 PAWNEE TRL",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338032171",
            "telephone_number": "863-682-5538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1324 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338054543",
            "telephone_number": "863-687-1359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARREDONDO",
        "first_name": "NATHALY",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-22",
        "last_updated": "2013-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "RN9242686",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "RN9242686",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.