Individual provider Active NPI

Taylor Eileen Roberts, APRN

  • Family Nurse Practitioner
  • New Smyrna Beach, FL
National Provider Identifier
1982379038
Registry record updated Aug 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11014574 Issued in FL
Practice address
2777 Neverland Dr
New Smyrna Beach, FL 32168-2480
Phone
(386) 847-3948
NPI assigned
Aug 11, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2021

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 APRN11014574 FL Primary

Addresses

Primary practice location

2777 Neverland Dr
New Smyrna Beach, FL 32168-2480

Mailing address

2777 Neverland Dr
New Smyrna Beach, FL 32168-2480
Phone (386) 847-3948

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20220818001928 FL Practitioner - Nurse Practitioner 9638552987 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mobile Visiting Practitioners, LLCGroup PAC ID 7810239100, 25 clinicians

Practice addresses (Care Compare)

140 S Beach St
Suite 202
Daytona Beach, FL 32114-4409
Phone (888) 506-8836

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN11014574FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Health Services of Florida LLC CurrentSince Jun 1, 2022 Accepting new patients
Mobile Visiting Practitioners, LLC CurrentSince Jun 1, 2022 Accepting new patients

Locations

140 S Beach St
Ste 202
Daytona Beach, FL 32114
Phone (888) 506-8836

Organizations & group practices 2

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": "1628640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1982379038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2777 NEVERLAND DR",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321682480",
            "telephone_number": "386-847-3948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2777 NEVERLAND DR",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321682480",
            "telephone_number": "386-847-3948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "TAYLOR",
        "middle_name": "EILEEN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-11",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11014574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Smyrna Beach, FL

Sources for this page

Verify at the official NPI Registry.