Individual provider Active NPI

Melissa Connors, APRN, FNP-BC

  • Family Nurse Practitioner
  • Fort Myers, FL
National Provider Identifier
1790384154
Registry record updated Oct 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11008845 Issued in FL
Practice address
15609 Fiddlesticks Blvd
Fort Myers, FL 33912-3902
Phone
(239) 896-6585
NPI assigned
Oct 18, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11008845 FL Primary

Addresses

Primary practice location

15609 Fiddlesticks Blvd
Fort Myers, FL 33912-3902

Mailing address

15609 Fiddlesticks Blvd
Fort Myers, FL 33912-3902
Phone (239) 896-6585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2350 N University Dr
Unit 841224
Pembroke Pines, FL 33084-4100

2605 W Atlantic Ave
Suite D102
Delray Beach, FL 33445-4416

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN11008845FLMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1602979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602979200000",
    "number": "1790384154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15609 FIDDLESTICKS BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339123902",
            "telephone_number": "239-896-6585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15609 FIDDLESTICKS BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339123902",
            "telephone_number": "239-896-6585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNORS",
        "first_name": "MELISSA",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-18",
        "last_updated": "2020-10-18",
        "certification_date": "2020-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11008845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.