Viky Divertie, ARNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

ARNP2180342 Issued in FL

Practice address

12303 San Jose Blvd
Jacksonville, FL 32223-2640

Phone

(904) 288-0277

Fax

(904) 288-0414

NPI assigned

Jun 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

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

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.

• Bagnoli and Salah Partnership

  • Pulmonary Disease Physician
  • Jacksonville, FL
  • NPI 1144287335
  NPD (past)
• First Coast Cardiovascular Institute LLC

  • Cardiac Rehabilitation Clinic/Center
  • Jacksonville, FL
  • NPI 1013711498
  NPD (past)
• Solantic LLC

  • Urgent Care Clinic/Center
  • Jacksonville, FL
  • NPI 1609822592
  NPD (past)

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283990400000",
    "number": "1790722684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8711 PERIMETER PARK BLVD",
            "address_2": "SUITE 6",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322166388",
            "telephone_number": "904-223-2330",
            "fax_number": "904-223-3149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12303 SAN JOSE BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322232640",
            "telephone_number": "904-288-0277",
            "fax_number": "904-288-0414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIVERTIE",
        "first_name": "VIKY",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-01",
        "last_updated": "2010-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP2180342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer M Ditges, M.S. CCC-SLP
• Rachel Abigail Ditrapani, MD
• Celeste Eromacys Ditroia, BA, MS, LPC, LMHC
• Kathleen E Ditto, MA OTR
• Gavin Douglas Divertie, MD
• Divine Comfort Care
• Divine Enterprises, Inc.
• Divine Healing Homecare LLC
• Divine Healing Homecare LLC
• Divine Homemaker & Companion

• Nurse Practitioner in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2010; 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.