Individual provider Active NPI

Tina Wells, ARNP

  • Gerontology Nurse Practitioner
  • Celebration, FL
National Provider Identifier
1881071652
Registry record updated Mar 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
ARNP9263003 Issued in FL
Practice address
400 Celebration PL Ste A150
Celebration, FL 34747-4970
Phone
(407) 303-3837
Fax
(407) 303-3838
NPI assigned
Apr 30, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X ARNP9263003 FL
Gerontology Nurse Practitioner 363LG0600X ARNP9263003 FL Primary

Addresses

Primary practice location

400 Celebration PL Ste A150
Celebration, FL 34747-4970

Mailing address

400 Celebration PL Ste A150
Celebration, FL 34747-4970
Phone (407) 303-3837

Other practice location 1

400 Celebration Pl Ste A240
Celebration, FL 34747-4970
Phone (407) 764-4079

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
I20160622000775 FL Practitioner - Nurse Practitioner 7012208085 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
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

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ARNP9263003FLMDGerontology Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: twells73217@adventhealth.direct-ci.com

Organizations & group practices 1

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": "1430352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519948800000",
    "number": "1881071652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 CELEBRATION PL STE A150",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "347474970",
            "telephone_number": "407-303-3837",
            "fax_number": "407-303-3838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 CELEBRATION PL STE A150",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "347474970",
            "telephone_number": "407-303-3837",
            "fax_number": "407-303-3838"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Celebration Pl Ste A240",
            "address_purpose": "LOCATION",
            "city": "Celebration",
            "state": "FL",
            "postal_code": "347474970",
            "country_code": "US",
            "telephone_number": "407-764-4079",
            "fax_number": "407-303-4503",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WELLS",
        "first_name": "TINA",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-30",
        "last_updated": "2018-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP9263003",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "ARNP9263003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Celebration, FL

Sources for this page

Verify at the official NPI Registry.