Individual provider Active NPI

Darla L Bagwell, ARNP

  • Adult Health Nurse Practitioner
  • Fort Pierce, FL
National Provider Identifier
1801884028
Registry record updated May 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
ARNP3016352 Issued in FL
Practice address
356 E Midway Rd
Fort Pierce, FL 34982-7148
Phone
(772) 464-9746
Fax
(772) 464-9750
NPI assigned
Oct 11, 2005
Last updated
May 17, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X ARNP3016352 FL Primary

Addresses

Primary practice location

356 E Midway Rd
Fort Pierce, FL 34982-7148

Mailing address

356 E Midway Rd
Fort Pierce, FL 34982-7148
Phone (772) 464-9746

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
I20130924000502 FL Practitioner - Nurse Practitioner 4587806344 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midway Specialty Care Center IncGroup PAC ID 9638306087, 30 clinicians

Practice addresses (Care Compare)

356 E Midway Rd
Fort Pierce, FL 34982-7148
Phone (772) 464-9746

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP3016352FLMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Associates in Infectious Diseases CurrentSince Aug 1, 2013 Accepting new patients
Midway Specialty Care Center Inc CurrentSince Dec 14, 2013 Accepting new patients

Locations

356 E Midway Rd
Fort Pierce, FL 34982
Phone (772) 464-9746

1801 SE Hillmoor Dr
Ste C-207
Port St Lucie, FL 34952
Phone (772) 335-4234

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 2

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": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368748800000",
    "number": "1801884028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "356 E MIDWAY RD",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349827148",
            "telephone_number": "772-464-9746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "356 E MIDWAY RD",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349827148",
            "telephone_number": "772-464-9746",
            "fax_number": "772-464-9750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGWELL",
        "first_name": "DARLA",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-11",
        "last_updated": "2013-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP3016352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

Verify at the official NPI Registry.