Active NPI
Elizabeth Gnagy
- Psychiatry Physician
- Lakeland, FL
National Provider Identifier
1982075826
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- OS13100
- Practice address
- 122 E Main St # 131
Lakeland, FL 33801-4655 - Phone
- (863) 225-7097
- NPI assigned
- Oct 19, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction Medicine (Psychiatry & Neurology) Physician | 2084A0401X | OS13100 | FL | |
| Psychiatry Physician | 2084P0800X | OS13100 | FL | Primary |
Addresses
Primary practice location
122 E Main St # 131
Lakeland, FL 33801-4655
Mailing address
122 E Main St # 131
Lakeland, FL 33801-4655
Phone (863) 225-7097
Other practice location 1
3200 S University Dr
Davie, FL 33328-2018
Phone (954) 262-4100
Other names 1
- Elizabeth Hudson Martin
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Apr 21, 2025 through Apr 21, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS13100 | FL | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1445212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646784000000",
"number": "1982075826",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "122 E MAIN ST # 131",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338014655",
"telephone_number": "863-225-7097"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "122 E MAIN ST # 131",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338014655",
"telephone_number": "863-225-7097"
}
],
"practiceLocations": [
{
"address_1": "3200 S University Dr",
"address_purpose": "LOCATION",
"city": "Davie",
"state": "FL",
"postal_code": "333282018",
"country_code": "US",
"telephone_number": "954-262-4100",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GNAGY",
"first_name": "ELIZABETH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-10-19",
"last_updated": "2022-03-09",
"certification_date": "2022-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "2084A0401X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Addiction Medicine",
"state": "FL",
"license": "OS13100",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "FL",
"license": "OS13100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ELIZABETH",
"last_name": "HUDSON MARTIN",
"credential": "DO",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Lakeland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2022; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.