Mary Elizabeth Monticello Powell, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APRN2085022 Issued in FL

Practice address

410 S 11TH St
Lake Wales, FL 33853-4203

Phone

(863) 419-2188

Fax

(863) 419-2540

NPI assigned

Dec 22, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Mary Elizabeth Powell Other name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Florida Hospital Medical Group Inc

  • Family Medicine Physician
  • Orlando, FL
  • NPI 1225034234

  Nurse Practitioner

  Medicare reassignment NPD
• Florida Hospital Medical Group Inc

  • Prosthetic/Orthotic Supplier
  • Minneola, FL
  • NPI 1285591545
  NPD
• Peace River Center for Personal Development Inc

  • Psychiatry Physician
  • Wauchula, FL
  • NPI 1184370504
  NPD
• Peace River Center for Personal Development Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lakeland, FL
  • NPI 1538802939
  NPD (past)
• University Medical Service Association Inc

  • Durable Medical Equipment & Medical Supplies
  • Tampa, FL
  • NPI 1194276576
  NPD (past)
• Banner Greeley Specialists

  • Multi-Specialty Clinic/Center
  • Greeley, CO
  • NPI 1558595611
  NPD (past)
• Colorado State University

  • Clinic/Center
  • Fort Collins, CO
  • NPI 1528156437
  NPD (past)

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1972668754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 S 11TH ST",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534203",
            "telephone_number": "863-419-2188",
            "fax_number": "863-419-2540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 S 11TH ST",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534203",
            "telephone_number": "863-419-2188",
            "fax_number": "863-419-2540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTICELLO POWELL",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-22",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "5976",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP2085022",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN2085022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "POWELL",
            "middle_name": "ELIZABETH",
            "credential": "APRN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Mary Miller
• Richard S Miller, OD
• Mobile Tech Imaging LLC
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• Monica L. Vickers Associates
• Shameka Moore
• Matt Moraes, AA
• Morales & Humeres Consultancy LLC
• Anna K Moreau, RN
• Yira Morell Perez, SLPA

• Psychiatric/Mental Health Nurse Practitioner in Lake Wales, FL
• Providers in Lake Wales, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.