Unknown Individual – Family Nurse Practitioner, NPI 1508824699
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
24,232 NURSE PRACTITIONER in FL
Provider Addresses for Unknown Individual
3000 MURRELL RD UNIT 560135
ROCKLEDGE, FL 329567007
Phone: (321) 291-3589
Type: Location
PO BOX 560135
ROCKLEDGE, FL 329560135
Phone: (321) 291-3589
Type: Mailing
11212, Waples Mill Road, Random Hills, Fair Oaks, Fairfax County, Virginia, 22030, United States
SUITE 100
FAIRFAX, VA 22030
Phone: (571) 308-1900
Fax: (571) 308-1919
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $93.
Total Amount is formed as General ($93) + Research ($0) + Ownership ($0) = $93.
Last reported payment date: 2024-02-20 • Largest payer in this snapshot: ViiV Healthcare Company ($54).
Total Amount
$93
General + Research + Ownership
Payments
4
Total payment records
General Amount
$93
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-02-20
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ViiV Healthcare Company | $54 |
| Merck Sharp & Dohme LLC | $38 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2010-08-06
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20100806000240 | I | Nurse Practitioner | FL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 32956)
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