Concepcion Fornaris Caballero, APRN

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

11002534 Issued in FL

Practice address

6351 Adams St
Hollywood, FL 33023-1749

Phone

(954) 638-6924

NPI assigned

May 31, 2019

Last updated

May 31, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Amedisys Hospice, L.L.C.

  dba Amedisys Hospice of Brevard

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Melbourne, FL
  • NPI 1174200620
  Medicare reassignment NPD
• Compassionate Care Hospice of Lake and Sumter Inc

  dba Palliative Care Connections

  • Specialist
  • The Villages, FL
  • NPI 1770129504
  Medicare reassignment NPD
• Compassionate Care Hospice of Miami Dade and the Florida Keys, Inc.

  dba Palliative Care Connections

  • Specialist
  • Hialeah, FL
  • NPI 1982242459
  Medicare reassignment NPD
• Amedisys Hospice, L.L.C.

  dba Amedisys Hospice of Bluefield

  • Community Based Hospice Care Agency
  • Bluefield, WV
  • NPI 1902064892
  NPD

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

{
    "created_epoch": "1559260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559260800000",
    "number": "1922666312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6351 ADAMS ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330231749",
            "telephone_number": "954-638-6924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6351 ADAMS ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330231749",
            "telephone_number": "954-638-6924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORNARIS CABALLERO",
        "first_name": "CONCEPCION",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-31",
        "last_updated": "2019-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "11002534",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "11002534",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "11002534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• For Pedz Sake Inc
• Ronald Andrew Ford, M.D.
• Johanna M. Forero-Moylan, CRNA
• Katrina Forman, MSW, LCSW
• Nathaniel Hamilton Forman, M.D.
• Nanella Fornoni
• Anita Forrest
• Patricia Forsyth, ARNP
• Melanie Stovall Fortenberry, FNP
• Michael Fortney, CRNA

• Primary Care Nurse Practitioner in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Primary Care Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.