Individual provider Active NPI

Ellen A Branoff, ARNP

  • Family Nurse Practitioner
  • Ormond Beach, FL
National Provider Identifier
1962536029
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP 1002882 Issued in FL
Practice address
545 W Granada Blvd
Ormond Beach, FL 32174-5103
Phone
(386) 672-6750
Fax
(386) 677-7463
NPI assigned
Mar 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 ARNP 1002882 FL Primary

Addresses

Primary practice location

545 W Granada Blvd
Ormond Beach, FL 32174-5103

Mailing address

282 S Beach St
Ormond Beach, FL 32174-6422
Phone (386) 672-6243

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP 1002882FLMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962536029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "282 S BEACH ST",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321746422",
            "telephone_number": "386-672-6243",
            "fax_number": "673-677-7463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 W GRANADA BLVD",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745103",
            "telephone_number": "386-672-6750",
            "fax_number": "386-677-7463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANOFF",
        "first_name": "ELLEN",
        "middle_name": "A",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP 1002882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ormond Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.