Individual provider Active NPI

Danie Moly Coulombe

  • Nurse Practitioner
  • Kissimmee, FL
National Provider Identifier
1871262634
Registry record updated Aug 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11010414 Issued in FL
Practice address
2400 N Orange Blossom TRL Ste 205
Kissimmee, FL 34744-2307
Phone
(407) 944-5240
NPI assigned
Sep 7, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WG0000X 11010414 FL
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X 11010414 FL Primary

Addresses

Primary practice location

2400 N Orange Blossom TRL Ste 205
Kissimmee, FL 34744-2307

Mailing address

2400 N Orange Blossom TRL Ste 205
Kissimmee, FL 34744-2307

Other practice location 1

4929 Cortland Dr
Davenport, FL 33837-1765
Phone (603) 915-1730

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
I20220722000594 FL Practitioner - Nurse Practitioner 2163803172 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700

380 Celebration PL
FL 2
Celebration, FL 34747-4606
Phone (321) 939-3553

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11010414FLMDGeneral Practice Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Jul 3, 2022 Accepting new patients
Florida Hospital Medical Group Inc Single Specialty CurrentSince Jul 3, 2022 Accepting new patients

Locations

2400 N Orange Blossom Trl
Ste 205
Kissimmee, FL 34744
Phone (407) 944-5240

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

Interoperability endpoints

  • Direct secure messaging: dcoulombe92957@adventhealth.direct-ci.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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1630972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1871262634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 N ORANGE BLOSSOM TRL STE 205",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347442307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 N ORANGE BLOSSOM TRL STE 205",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347442307",
            "telephone_number": "407-944-5240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4929 Cortland Dr",
            "address_purpose": "LOCATION",
            "city": "Davenport",
            "state": "FL",
            "postal_code": "338371765",
            "country_code": "US",
            "telephone_number": "603-915-1730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COULOMBE",
        "first_name": "DANIE",
        "middle_name": "MOLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-07",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, General Practice",
            "state": "FL",
            "license": "11010414",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11010414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.