Individual provider Active NPI

Anne Mivida Petit-Homme, ARNP

  • Family Nurse Practitioner
  • West Palm Beach, FL
National Provider Identifier
1871261354
Registry record updated Aug 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11014223 Issued in FL
Practice address
1096 Forsythia LN
West Palm Beach, FL 33415-4533
Phone
(561) 891-2995
NPI assigned
Aug 31, 2021
Last updated
Aug 31, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2021

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 11014223 FL Primary

Addresses

Primary practice location

1096 Forsythia LN
West Palm Beach, FL 33415-4533

Mailing address

1096 Forsythia LN
West Palm Beach, FL 33415-4533
Phone (561) 891-2995

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
I20230622000479 FL Practitioner - Nurse Practitioner 4587022686 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MD Now Medical Centers IncGroup PAC ID 3971554825, 314 clinicians

Practice addresses (Care Compare)

9060 N Military TRL
Palm Beach Gardens, FL 33410-5972
Phone (561) 622-2442

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11014223FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MD Now Medical Centers Inc CurrentSince Apr 9, 2024 Accepting new patients
MD Now Medical Centers Inc CurrentSince Apr 9, 2024 Accepting new patients

Locations

1838 Rye Rd
#107
Bradenton, FL 34212
Phone (941) 462-2004

4570 Lantana Rd
Lake Worth, FL 33463
Phone (305) 949-4141

9060 N Military Trl
West Palm Beach, FL 33410
Phone (561) 622-2442

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

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.

NPI Registry JSON

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

{
    "created_epoch": "1630368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1871261354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1096 FORSYTHIA LN",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334154533",
            "telephone_number": "561-891-2995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1096 FORSYTHIA LN",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334154533",
            "telephone_number": "561-891-2995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETIT-HOMME",
        "first_name": "ANNE",
        "middle_name": "MIVIDA",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-31",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11014223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.