Individual provider Active NPI

Nicole Horn, APRN

  • Pediatric Nurse Practitioner
  • Melbourne, FL
National Provider Identifier
1972113025
Registry record updated Aug 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
APRN11008036 Issued in FL
Practice address
8095 Spyglass Hill Rd Ste 104
Melbourne, FL 32940-8290
Phone
(321) 241-6400
NPI assigned
Aug 4, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0200X APRN11008036 FL Primary

Addresses

Primary practice location

8095 Spyglass Hill Rd Ste 104
Melbourne, FL 32940-8290

Mailing address

3507 Cappio Dr
Melbourne, FL 32940-1317
Phone (631) 258-2410

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
APRN11008036FLMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Associates of Brevard LLC Single Specialty PastSince Aug 9, 2020 Accepting new patients

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": "1596499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596499200000",
    "number": "1972113025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3507 CAPPIO DR",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329401317",
            "telephone_number": "631-258-2410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8095 SPYGLASS HILL RD STE 104",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329408290",
            "telephone_number": "321-241-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORN",
        "first_name": "NICOLE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-04",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "APRN11008036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2020; 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.