Individual provider Active NPI

Nicole Sammons Patterson, M.D.

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Naples, FL
National Provider Identifier
1811158041
Registry record updated Aug 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
ME118369 Issued in FL
Practice address
11190 Health Park Blvd
Naples, FL 34110-5729
Phone
(239) 552-8572
NPI assigned
Jun 20, 2008
Last updated
Aug 27, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X ME118369 FL Primary

Addresses

Primary practice location

11190 Health Park Blvd
Naples, FL 34110-5729

Mailing address

11190 Health Park Blvd
Naples, FL 34110-5729
Phone (239) 552-8572

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140618001318 FL Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 6002030814 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Florida Emergency Management LLC CurrentSince Jul 1, 2014 Accepting new patients

Locations

11190 Health Park Blvd
Naples, FL 34110
Phone (239) 300-9721

350 7th St N
Naples, FL 34102
Phone (239) 436-5000

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, 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": "1213920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409097600000",
    "number": "1811158041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11190 HEALTH PARK BLVD",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341105729",
            "telephone_number": "239-552-8572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11190 HEALTH PARK BLVD",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341105729",
            "telephone_number": "239-552-8572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "NICOLE",
        "middle_name": "SAMMONS",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-20",
        "last_updated": "2014-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "FL",
            "license": "ME118369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

Verify at the official NPI Registry.