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Individual provider Active NPI

Lavern Angela Lewis Anderson, DNP

  • Adult Health Nurse Practitioner
  • Miami, FL
National Provider Identifier
1811172323
Registry record updated Jun 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APRN9189456 Issued in FL
Practice address
1611 NW 12 Avenue
Jackson Memorial Hospital
Miami, FL 33136-4615
Phone
(305) 585-7528
NPI assigned
Jan 2, 2008
Last updated
Jun 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2024

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 ARNP9189456 FL
Adult Health Nurse Practitioner 363LA2200X APRN9189456 FL Primary

Addresses

Primary practice location

1611 NW 12 Avenue
Jackson Memorial Hospital
Miami, FL 33136-4615

Mailing address

1611 NW 12TH Ave
Miami, FL 33136-1005
Phone (305) 585-7528

Other names 1

  • Lavern Angela Lewis Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100330000243 FL Practitioner - Nurse Practitioner 3476689498 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1611 NW 12 Ave
Miami, FL 33136-1005
Phone (305) 585-1111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.01 of 100Reported as group
Quality
72.99
Promoting interoperability
82
Improvement activities
40
Cost
78.71

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN9189456FLMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Public Health Trust of Miami Dade County Florida CurrentSince Feb 4, 2010 Accepting new patients
Public Health Trust of Miami Dade County Florida CurrentSince Feb 4, 2010 Accepting new patients
Lewis Healthcare Consultants LLC Current Accepting new patients
Public Health Trust of Dade County Florida Past Accepting new patients

Locations

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

1611 NW 12th Ave
#600B
Miami, FL 33136
Phone (305) 355-1245

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 4

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.

Hospital & facility affiliations 23

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1199232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718323200000",
    "number": "1811172323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 NW 12TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361005",
            "telephone_number": "305-585-7528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 NW 12 AVENUE",
            "address_2": "JACKSON MEMORIAL HOSPITAL",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331364615",
            "telephone_number": "305-585-7528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS ANDERSON",
        "first_name": "LAVERN",
        "middle_name": "ANGELA",
        "name_prefix": "Dr.",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-02",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9189456",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN9189456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAVERN",
            "last_name": "LEWIS",
            "middle_name": "ANGELA",
            "credential": "DNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.