NICOLE ANN SPALL (APRN-BC) – Family Nurse Practitioner, NPI 1780167809
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for NICOLE ANN SPALL (APRN-BC)
12112 KNOLL ST
TAMPA, FL 336124011
Phone: (813) 857-4200
Type: Mailing
1000, East Tarpon Avenue, Tarpon Springs, Pinellas County, Florida, 34689, United States
TARPON SPRINGS, FL 346895438
Phone: (727) 937-4203
Type: Location
16131 BELLE MEADE BLVD
ODESSA, FL 335563309
Phone: (813) 857-4200
Type: Mailing
6750 N ANDREWS AVE
FORT LAUDERDALE, FL 333092173
Phone: (800) 275-3243
Type: Location
157 BALTIMORE ST STE 102
CUMBERLAND, MD 215022472
Phone: (301) 722-0148
Fax: (833) 903-0130
Type: Mailing
1507 S TUTTLE AVE
SARASOTA, FL 342392608
Phone: (301) 722-0484
Fax: (833) 903-0130
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2018-11-14
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 |
|---|---|---|---|---|
| I20181114002305 | 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 33612)
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