Individual provider Active NPI

Cynthia A Feagan, ARNP

  • Nurse Practitioner
  • Fort Myers, FL
National Provider Identifier
1881674901
Registry record updated Jun 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
9388322 Issued in FL
Practice address
14071 Metropolis Ave
Fort Myers, FL 33912-4330
Phone
(239) 694-7546
Fax
(239) 694-1571
NPI assigned
Jan 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 9388322 FL Primary

Addresses

Primary practice location

14071 Metropolis Ave
Fort Myers, FL 33912-4330

Mailing address

14071 Metropolis Ave
Fort Myers, FL 33912-4330
Phone (239) 694-7546

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
I20151123001861 FL Practitioner - Nurse Practitioner 0143364745 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
99.38 of 100Reported as individual
Quality
98.76
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9388322FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Solutions a Profession Limited Liability Com CurrentSince Feb 12, 2021 Accepting new patients

Locations

2002 Del Prado Blvd S
Ste 205
Cape Coral, FL 33990
Phone (239) 471-2818

14071 Metropolis Ave
Fort Myers, FL 33912
Phone (239) 694-7546

Interoperability endpoints

  • Direct secure messaging: cynthia12@dermatologysolutions.emadirect.md

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.

NPI Registry JSON

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624492800000",
    "number": "1881674901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14071 METROPOLIS AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124330",
            "telephone_number": "239-694-7546",
            "fax_number": "239-694-1571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14071 METROPOLIS AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124330",
            "telephone_number": "239-694-7546",
            "fax_number": "239-694-1571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEAGAN",
        "first_name": "CYNTHIA",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-17",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "9388322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.