Individual provider Active NPI

Misty V Gaddis, DNP

  • Family Nurse Practitioner
  • Port Saint Lucie, FL
National Provider Identifier
1841852266
Registry record updated Mar 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9194155 Issued in FL
Practice address
3281 SW Cohutta St
Port Saint Lucie, FL 34953-4647
Phone
(561) 985-0342
NPI assigned
Jul 5, 2019
Last updated
Mar 17, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2026

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 9194155 FL Primary

Addresses

Primary practice location

3281 SW Cohutta St
Port Saint Lucie, FL 34953-4647

Mailing address

1729 NW Saint Lucie West Blvd # 1128
Port Saint Lucie, FL 34986-2501
Phone (561) 985-0342

Other practice location 1

2351 SW Martin Hwy
Palm City, FL 34990-3222
Phone (772) 324-9337

Other practice location 2

1066 SW Gatlin Blvd
Port St Lucie, FL 34953-3223
Phone (772) 879-8080

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
I20210623001517 FL Practitioner - Nurse Practitioner 7911308341 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Back in Action Medical Center LLCGroup PAC ID 7810272473, 12 clinicians

Practice addresses (Care Compare)

1066 SW Gatlin Blvd
Port St. Lucie, FL 34953-3223
Phone (772) 879-8080

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9194155FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Back in Action Medical Center LLC CurrentSince May 19, 2021 Accepting new patients
Back in Action Medical Center LLC CurrentSince May 19, 2021 Accepting new patients

Locations

2351 SW Martin Hwy
Palm City, FL 34990
Phone (772) 324-8337

1066 SW Gatlin Blvd
Port St Lucie, FL 34953
Phone (772) 324-9337

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GCBABD
  • Direct secure messaging: misti.gaddis@115443077021700.direct.elationemr.com

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1562284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773705600000",
    "number": "1841852266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1729 NW SAINT LUCIE WEST BLVD # 1128",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349862501",
            "telephone_number": "561-985-0342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3281 SW COHUTTA ST",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349534647",
            "telephone_number": "561-985-0342"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2351 SW Martin Hwy",
            "address_purpose": "LOCATION",
            "city": "Palm City",
            "state": "FL",
            "postal_code": "349903222",
            "country_code": "US",
            "telephone_number": "772-324-9337",
            "fax_number": "772-324-9347",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1066 SW Gatlin Blvd",
            "address_purpose": "LOCATION",
            "city": "Port St Lucie",
            "state": "FL",
            "postal_code": "349533223",
            "country_code": "US",
            "telephone_number": "772-879-8080",
            "fax_number": "772-324-9347",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GADDIS",
        "first_name": "MISTY",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-05",
        "last_updated": "2026-03-17",
        "certification_date": "2026-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9194155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

Verify at the official NPI Registry.