Individual provider Active NPI

Tammy Bagwell, FNP-C

  • Family Nurse Practitioner
  • Naples, FL
National Provider Identifier
1821577230
Registry record updated Jun 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9463628 Issued in FL
Practice address
720 Goodlette Rd Ste 500
Naples, FL 34102-5656
Phone
(239) 566-7676
NPI assigned
Aug 8, 2018
Last updated
Jun 16, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2021

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 9463628 FL Primary

Addresses

Primary practice location

720 Goodlette Rd Ste 500
Naples, FL 34102-5656

Mailing address

720 Goodlette Rd Ste 500
Naples, FL 34102-5656
Phone (239) 566-7676

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
I20190909000478 FL Practitioner - Nurse Practitioner 8527397173 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
85.1 of 100Reported as group
Quality
85.84
Improvement activities
40
Cost
69.22

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Shahla Medical Group, PA CurrentSince Jul 9, 2019 Accepting new patients

Locations

8800 Terrene Ct
Ste 102
Bonita Springs, FL 34135
Phone (239) 948-3444

Interoperability endpoints

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

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": "1533686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1821577230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 GOODLETTE RD STE 500",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341025656",
            "telephone_number": "239-566-7676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 GOODLETTE RD STE 500",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341025656",
            "telephone_number": "239-566-7676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGWELL",
        "first_name": "TAMMY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-08",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9463628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

Verify at the official NPI Registry.