Ludgy Renaud Supplice, FNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

9265816 Issued in FL

Practice address

11261 SW 164TH Ter
Miami, FL 33157-2717

Phone

(786) 543-3081

NPI assigned

Aug 29, 2018

Last updated

Dec 14, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Palmetto Comprehensive Health Center

  • Psychiatric/Mental Health Nurse Practitioner
  • Miami, FL
  • NPI 1811886922
  Medicare reassignment NPD
• Forefront Telecare Inc

  • Psychiatry Physician
  • Dallas, TX
  • NPI 1174035612

  FL

  Medicare reassignment NPD

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

{
    "created_epoch": "1535500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1841772506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11261 SW 164TH TER",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331572717",
            "telephone_number": "786-543-3081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11261 SW 164TH TER",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331572717",
            "telephone_number": "786-543-3081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUPPLICE",
        "first_name": "LUDGY",
        "middle_name": "RENAUD",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-29",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "9265816",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "9265816",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Superstar Medical Group, Inc
• Geraldine Superville, ARNP
• Supervista North America
• Mark Supino, M.D.
• Andrea Suplick, ARNP
• Supplies Care DME Corp
• Support & Solution East Coast, Inc
• Support Care Group, Inc.
• Support Coordinator & Management Services, Inc.
• Supportive Health Services, PLLC

• Psychiatric/Mental Health Nurse Practitioner in Miami, FL
• Providers in Miami, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.