Individual provider Active NPI

Ronda Lee Mobley, APRN- FNP-C

  • Family Nurse Practitioner
  • Melbourne, FL
National Provider Identifier
1871104059
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11008222 Issued in FL
Practice address
2120 Sarno Rd
Melbourne, FL 32935-3084
Phone
(321) 241-6800
Fax
(321) 241-6890
NPI assigned
Aug 12, 2020
Last updated
Feb 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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 APRN11008222 FL Primary

Addresses

Primary practice location

2120 Sarno Rd
Melbourne, FL 32935-3084

Mailing address

PO Box 1137
Melbourne, FL 32902-1137
Phone (321) 952-9696

Other practice location 1

3855 S US Highway 1
Fort Pierce, FL 34982-6621
Phone (772) 462-5646

Other identifiers 1

IdentifierTypeStateIssuer
108465900MedicaidFL

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
I20240207001246 FL Practitioner - Nurse Practitioner 9133510191 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11008222FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brevard Health Alliance Inc CurrentSince Jan 3, 2024 Accepting new patients
Brevard Health Alliance, Inc. CurrentSince Jan 3, 2024 Accepting new patients
Brevard Health Alliance Inc Past Accepting new patients

Locations

775 Malabar Rd
Malabar, FL 32950
Phone (321) 722-8435

17 Silver Palm Ave
Melbourne, FL 32901
Phone (321) 725-9041

2120 Sarno Rd
Melbourne, FL 32935
Phone (321) 952-9696

5270 Babcock St NE
Ste 1
Palm Bay, FL 32905
Phone (321) 676-5996

7227 N US Highway 1
Port St John, FL 32927
Phone (321) 631-3693

220 Barton Blvd
Unit C14
Rockledge, FL 32955
Phone (321) 639-5177

1537 N Singleton Ave
Titusville, FL 32796
Phone (321) 268-0267

Interoperability endpoints

  • Direct secure messaging: ronda.mobley@bha.eclinicaldirectplus.com

Organizations & group practices 3

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": "1597190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1871104059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1137",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329021137",
            "telephone_number": "321-952-9696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 SARNO RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329353084",
            "telephone_number": "321-241-6800",
            "fax_number": "321-241-6890"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3855 S US Highway 1",
            "address_purpose": "LOCATION",
            "city": "Fort Pierce",
            "state": "FL",
            "postal_code": "349826621",
            "country_code": "US",
            "telephone_number": "772-462-5646",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOBLEY",
        "first_name": "RONDA",
        "middle_name": "LEE",
        "credential": "APRN- FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-12",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11008222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "108465900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.