Individual provider Active NPI

Sandryn Marie Taylor- Wysiekierski, APN

  • Nurse Practitioner
  • Lake Mary, FL
National Provider Identifier
1962951202
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11016848 Issued in FL
Practice address
737 Stirling Center PL Ste 1809
Lake Mary, FL 32746-5715
Phone
(407) 878-6008
NPI assigned
Sep 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11016848 FL Primary

Addresses

Primary practice location

737 Stirling Center PL Ste 1809
Lake Mary, FL 32746-5715

Mailing address

6826 Hyland Oaks Dr
Orlando, FL 32818-8301
Phone (732) 763-2806

Other practice location 1

425 S Hunt Club Blvd
Apopka, FL 32703-4947
Phone (407) 786-4080

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11016848FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Huntclub Pediatric Associates, LLC PastSince Dec 22, 2024 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GHAADD

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.

NPI Registry JSON

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

{
    "created_epoch": "1475020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1962951202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6826 HYLAND OAKS DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328188301",
            "telephone_number": "732-763-2806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "737 STIRLING CENTER PL STE 1809",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327465715",
            "telephone_number": "407-878-6008"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "425 S Hunt Club Blvd",
            "address_purpose": "LOCATION",
            "city": "Apopka",
            "state": "FL",
            "postal_code": "327034947",
            "country_code": "US",
            "telephone_number": "407-786-4080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAYLOR- WYSIEKIERSKI",
        "first_name": "SANDRYN",
        "middle_name": "MARIE",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-28",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11016848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2024; 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.