Individual provider Active NPI

Tamara Patrice Neilson, PHMNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Port St Lucie, FL
National Provider Identifier
1881567436
Registry record updated Jun 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN11042384 Issued in FL
Practice address
1380 SW Import Dr Ste 205
Port St Lucie, FL 34953-2424
Phone
(772) 210-7554
NPI assigned
Sep 29, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11042384 FL Primary

Addresses

Primary practice location

1380 SW Import Dr Ste 205
Port St Lucie, FL 34953-2424

Mailing address

1380 SW Import Dr Ste 205
Port St Lucie, FL 34953-2424
Phone (772) 210-7554

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
I20260129003112 FL Practitioner - Nurse Practitioner 0345728580 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11042384FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Learning to Achieve Wellness Inc Psychiatric/Mental Health CurrentSince Jan 1, 2026 Accepting new patients

Locations

413 W Robertson St
Ste B
Brandon, FL 33511
Phone (813) 657-4711

16332 Cortez Blvd
Ste F
Brooksville, FL 34601

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.

NPI Registry JSON

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

{
    "created_epoch": "1759104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780963200000",
    "number": "1881567436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 SW IMPORT DR STE 205",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349532424",
            "telephone_number": "772-210-7554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 SW IMPORT DR STE 205",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349532424",
            "telephone_number": "772-210-7554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEILSON",
        "first_name": "TAMARA",
        "middle_name": "PATRICE",
        "credential": "PHMNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-29",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11042384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.