Nina Teresa Phelps, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN11006026 Issued in FL

Practice address

220 Barton Blvd Unit C-14
Rockledge, FL 32955-2742

Phone

(321) 241-6800

Fax

(321) 241-6890

NPI assigned

Aug 17, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

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 and National Provider Directory roles.

• Brevard Health Alliance Inc

  • Federally Qualified Health Center (FQHC)
  • Melbourne, FL
  • NPI 1013355726
  Medicare reassignment NPD
• Brevard Health Alliance Inc

  • Federally Qualified Health Center (FQHC)
  • Palm Bay, FL
  • NPI 1316004815
  NPD
• Brevard Health Alliance, Inc.

  dba BHA Silver Palm Pharmacy

  • Community/Retail Pharmacy
  • Melbourne, FL
  • NPI 1508735150
  NPD

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

{
    "created_epoch": "1597622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696464000000",
    "number": "1871105411",
    "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",
            "fax_number": "321-952-7937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 BARTON BLVD UNIT C-14",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329552742",
            "telephone_number": "321-241-6800",
            "fax_number": "321-241-6890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELPS",
        "first_name": "NINA",
        "middle_name": "TERESA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-17",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11006026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109626700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL DOH",
            "identifier": "APRN11006026",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Periodontal Artistry, PLLC
• Dorothy Lorraine Perver, MA, LMHC
• Sarah Laurel Peters, MA
• Elysa Petersen, LMHC
• Pfk513 LLC (Neurology X)
• Patricia June Philbrick, APRN
• Hance Phillips
• Physical Medicine & Rehab of Brevard, P.a.
• Shannon Piatek, PHARM.D.
• Maggie Lin Pierce

• Family Nurse Practitioner in Rockledge, FL
• Providers in Rockledge, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.