Individual provider Active NPI

Andrea Margaret Bytheway

  • Nurse Practitioner
  • Palatka, FL
National Provider Identifier
1831748623
Registry record updated Nov 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP11003894 Issued in FL
Practice address
6500 Crill Ave
Palatka, FL 32177-9230
Phone
(386) 326-0575
NPI assigned
Sep 5, 2019
Last updated
Nov 17, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP11003894 FL Primary

Addresses

Primary practice location

6500 Crill Ave
Palatka, FL 32177-9230

Mailing address

6500 Crill Ave
Palatka, FL 32177-9230
Phone (386) 326-0575

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
I20210205000148 FL Practitioner - Nurse Practitioner 6507270303 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Express Urgent Care, LLCGroup PAC ID 5991133027, 5 clinicians

Practice addresses (Care Compare)

6500 Crill Ave
Suite 5
Palatka, FL 32177-9230
Phone (386) 326-0575

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP11003894FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Express Urgent Care, LLC CurrentSince Jan 1, 2021 Accepting new patients

Locations

6500 Crill Ave
Palatka, FL 32177
Phone (386) 326-0575

6500 Crill Ave
Ste 5
Palatka, FL 32177
Phone (386) 326-0575

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": "1567641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1831748623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6500 CRILL AVE",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321779230",
            "telephone_number": "386-326-0575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 CRILL AVE",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321779230",
            "telephone_number": "386-326-0575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYTHEWAY",
        "first_name": "ANDREA",
        "middle_name": "MARGARET",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-05",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP11003894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palatka, FL

Sources for this page

Verify at the official NPI Registry.