Individual provider Active NPI

Maranda Irvin, FNP-C

  • Family Nurse Practitioner
  • Navarre, FL
National Provider Identifier
1932094414
Registry record updated Jun 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11040190 Issued in FL
Practice address
2011 Eagle LN
Navarre, FL 32566-8377
Phone
(217) 474-4859
NPI assigned
Jun 12, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11040190 FL Primary

Addresses

Primary practice location

2011 Eagle LN
Navarre, FL 32566-8377

Mailing address

2011 Eagle LN
Navarre, FL 32566-8377
Phone (217) 474-4859

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
I20251009001274 FL Practitioner - Nurse Practitioner 4688171291 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Noles Medical ServicesGroup PAC ID 7416364393, 7 clinicians

Practice addresses (Care Compare)

996 Airport Rd
Destin, FL 32541-2824
Phone (313) 600-5589

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11040190FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Noles Medical Services CurrentSince Aug 1, 2025 Accepting new patients

Locations

996 Airport Rd
Destin, FL 32541
Phone (615) 338-1250

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": "1749686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749686400000",
    "number": "1932094414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2011 EAGLE LN",
            "city": "NAVARRE",
            "state": "FL",
            "postal_code": "325668377",
            "telephone_number": "217-474-4859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 EAGLE LN",
            "city": "NAVARRE",
            "state": "FL",
            "postal_code": "325668377",
            "telephone_number": "217-474-4859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRVIN",
        "first_name": "MARANDA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-12",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11040190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Navarre, FL

Sources for this page

Verify at the official NPI Registry.