Individual provider Active NPI

Annette Marjorie Channer, ARNP

  • Gerontology Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1942745278
Registry record updated Dec 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
ARNP 9197752 Issued in FL
Practice address
436 Pepin Dr
Orlando, FL 32825-6919
Phone
(407) 334-7305
NPI assigned
Dec 22, 2016
Last updated
Dec 22, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X ARNP 9197752 FL Primary

Addresses

Primary practice location

436 Pepin Dr
Orlando, FL 32825-6919

Mailing address

436 Pepin Dr
Orlando, FL 32825-6919
Phone (407) 334-7305

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
I20240718001848 FL Practitioner - Nurse Practitioner 3072059716 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ARNP 9197752FLMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Transitional Care Specialists LLC CurrentSince Jun 1, 2025 Accepting new patients
Inpatient Medicine Associates Imac PL CurrentSince May 15, 2024 Accepting new patients
Orlando Tele Clinic LLC CurrentSince May 15, 2024 Accepting new patients
Imac Hospitalists LLC Past Accepting new patients

Locations

11954 Narcoossee Rd
Ste 2
Orlando, FL 32832
Phone (407) 335-3549

7727 Lk Under Hl
Orlando, FL 32822
Phone (407) 303-6413

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1482364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482364800000",
    "number": "1942745278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 PEPIN DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328256919",
            "telephone_number": "407-334-7305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "436 PEPIN DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328256919",
            "telephone_number": "407-334-7305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANNER",
        "first_name": "ANNETTE",
        "middle_name": "MARJORIE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-22",
        "last_updated": "2016-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "ARNP 9197752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.