Individual provider Active NPI

Tammy W Hernandez

  • General Practice Registered Nurse
  • Kissimmee, FL
National Provider Identifier
1831860543
Registry record updated Aug 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
RN9194518 Issued in FL
Practice address
2275 Fortune Rd
Kissimmee, FL 34744-4404
Phone
(407) 201-5179
Fax
(407) 624-5905
NPI assigned
Sep 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Support Registered Nurse 163WN1003X RN9194518 FL
General Practice Registered Nurse 163WG0000X RN9194518 FL Primary

Addresses

Primary practice location

2275 Fortune Rd
Kissimmee, FL 34744-4404

Mailing address

2322 Lily Pad LN
Kissimmee, FL 34743-3993
Phone (617) 888-2546

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RN9194518FLMDGeneral Practice Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Lets Be Different Inc General Practice CurrentSince Sep 1, 2021 Accepting new patients

Locations

2275 Fortune Rd
Kissimmee, FL 34744
Phone (407) 201-5179

2326 Fortune Rd
Kissimmee, FL 34744

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1632268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1831860543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2322 LILY PAD LN",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347433993",
            "telephone_number": "617-888-2546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2275 FORTUNE RD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347444404",
            "telephone_number": "407-201-5179",
            "fax_number": "407-624-5905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "TAMMY",
        "middle_name": "W",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-22",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WN1003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Nutrition Support",
            "state": "FL",
            "license": "RN9194518",
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "FL",
            "license": "RN9194518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.