Individual provider Active NPI

Paula Stowell, ARNP

  • Family Nurse Practitioner
  • St Augustine, FL
National Provider Identifier
1891714564
Registry record updated Aug 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2520572 Issued in FL
Practice address
167 Palencia Village Dr
Ste 101
St Augustine, FL 32095-8450
Phone
(904) 224-5108
Fax
(866) 334-0650
NPI assigned
Jul 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X ARNP2520572 FL
Family Nurse Practitioner 363LF0000X 2520572 FL Primary

Addresses

Primary practice location

167 Palencia Village Dr
Ste 101
St Augustine, FL 32095-8450

Mailing address

PO Box 2230
St Augustine, FL 32085-2230
Phone (904) 824-4990

Other identifiers 2

IdentifierTypeStateIssuer
003144000MedicaidFL
Y6053OtherFLBCBS

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
I20070213000578 FL Practitioner - Nurse Practitioner 2163424672 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Island Doctors Intrastate LLCGroup PAC ID 5395161186, 74 clinicians

Practice addresses (Care Compare)

2460 Old Moultrie Rd
Suite 5
St Augustine, FL 32086-4198
Phone (904) 797-5740

Hospital & facility affiliations

  • Vitas Healthcare Corporation of Florida Hospice, Melbourne, FL, CCN 101545

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2520572FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Roy H Hinman MD PA CurrentSince Mar 10, 2018 Accepting new patients
Island Doctors Intrastate LLC CurrentSince Feb 5, 2021 Accepting new patients
James M Grimes Orthopaedics LLC PastSince Dec 21, 2021 Accepting new patients

Locations

199 S US Highway 17
Ste A
East Palatka, FL 32131
Phone (386) 312-0250

167 Palencia Village Dr
Saint Augustine, FL 32095

167 Palencia Village Dr
#101
Saint Augustine, FL 32095
Phone (904) 224-5108

2460 Old Moultrie Rd
Ste 2
St Augustine, FL 32086
Phone (904) 293-0299

100 Arricola Ave
St Augustine, FL 32080
Phone (904) 825-4368

2460 Old Moultrie Rd
Ste 5
St Augustine, FL 32086
Phone (904) 794-7870

103 Anastasia Blvd
St Augustine, FL 32080
Phone (904) 825-4747

Organizations & group practices 3

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 4

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314057600000",
    "number": "1891714564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2230",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320852230",
            "telephone_number": "904-824-4990",
            "fax_number": "904-824-2226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 PALENCIA VILLAGE DR",
            "address_2": "STE 101",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320958450",
            "telephone_number": "904-224-5108",
            "fax_number": "866-334-0650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOWELL",
        "first_name": "PAULA",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2011-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "ARNP2520572",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "2520572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003144000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Y6053",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.