PRAXIDES MUKOCHE MBAKAYA-CHEN (NPI# 1700168085) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700168085 |
| Entity Type | Individual |
| Full Name | PRAXIDES MUKOCHE MBAKAYA-CHEN |
| Credential | ARNP |
| Practice Address |
2020 Talley Rd Leesburg FL 34748-3426 |
| Mailing Address |
5548 Saddleback Ct Lady Lake FL 32159-6015 |
| Practice Telephone | 3523157800 |
| Practice Fax Number | 3523606582 |
| Mailing Telephone | 9086448361 |
| Mailing Fax Number | 3523606582 |
| Enumeration Date | 2011-09-13 |
| Last Update Date | 2012-10-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | ARNP 9323763 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 004023800 | 05 | |
| MEDICARE PTAN | FK403Z | 01 |
| Street Address |
2020 TALLEY RD |
| City | LEESBURG |
| State | FL |
| Zip Code | 34748-3426 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902802002 | Lifestream Behavioral Center Inc | Psychiatric Residential Treatment Facility | 2020 Talley Rd, Leesburg, FL 34748-3426 | 2005-06-23 |
| 1013421569 | Saad Siddiqui | Physician Assistant | 2020 Talley Rd, Leesburg, FL 34748-3426 | 2017-11-20 |
| 1801310602 | Lindsey Pollen | Counselor | 2020 Talley Rd, Leesburg, FL 34748-3426 | 2017-08-02 |
| 1619409463 | Julia M Palomino | Social Worker | 2020 Talley Rd, Leesburg, FL 34748-3426 | 2017-03-31 |
| 1285175059 | Olga Rodriguez-burgos | Counselor | 2020 Talley Rd, Leesburg, FL 34748-3426 | 2017-03-14 |
| 1093258642 | Nageley Michel | Nurse Practitioner | 2020 Talley Rd, Leesburg, FL 34748-3426 | 2016-11-30 |
| 1518310630 | Michelle Joop | Social Worker | 2020 Talley Rd, Leesburg, FL 34748-3426 | 2016-07-14 |
| 1871940783 | Abid Darr | Psychiatry & Neurology | 2020 Talley Rd, Leesburg, FL 34748-3426 | 2016-05-20 |
| 1063871572 | Steven Dolliver | Counselor | 2020 Talley Rd, Leesburg, FL 34748-3426 | 2016-02-12 |
| 1518326180 | Darla Peters | Counselor | 2020 Talley Rd, Leesburg, FL 34748-3426 | 2016-02-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437610243 | Ashley Shamsa Martin | Behavior Technician | 292 Bent Oak Ct, Leesburg, FL 34748 | 2019-03-26 |
| 1891278875 | Luis O Aponte Mendoza | Physician Assistant | 704 Doctors Ct., Suite 101, Leesburg, FL 34748 | 2018-09-14 |
| 1881197903 | Physician Associates LLC | Internal Medicine | 22316 Us Highway 27, Leesburg, FL 34748 | 2018-03-15 |
| 1184136145 | Infinite Support Services LLC | In Home Supportive Care | 129 Grove Ridge Circle, 104, Leesburg, FL 34748 | 2017-10-31 |
| 1619403037 | Massage and Wellness Care | Health Maintenance Organization | 1218 W. Dixie Ave, Suite A, Leesburg, FL 34748 | 2017-05-04 |
| 1497202675 | Prime Radiology of Leesburg Inc | Radiology | 600 N W Blvd, Suite E, Leesburg, FL 34748 | 2016-09-06 |
| 1023480332 | Juanita Elizabeth Simpson | Contractor | 1911 Harcourt Drive, Leesburg, FL 34748 | 2015-10-26 |
| 1467835900 | Serenity Choice Place, LLC | Community/Behavioral Health | 721 Balmoral Circle, Leesburg, FL 34748 | 2015-07-01 |
| 1356738397 | Touching Heart's Group Homes, LLC | Community/Behavioral Health | 31809 Sunpark Cir, Leesburg, FL 34748 | 2015-04-16 |
| 1386035269 | Adventist Health System/sunbelt, Inc. | Clinic/Center | 1103 N 14th Street, Leesburg, FL 34748 | 2015-02-12 |
| Find all providers in zip 34748 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316552110 | Susan Ashley Parker Pinson | Nurse Practitioner | 176 Saint Clair Dr, Leesburg, GA 31763-3225 | 2020-09-09 |
| 1467091629 | Dr. Coretta D. Gervin Healthcare | Nurse Practitioner | 116 Beowulf Ln, Leesburg, GA 31763-5831 | 2020-01-04 |
| 1144793472 | Jennifer Joan Pollard | Nurse Practitioner | 601 E Dixie Ave Ste 901, Leesburg, FL 34748-7308 | 2019-01-09 |
| 1609195338 | Carissa Dear | Nurse Practitioner | 211 Gibson St Nw Ste 215, Leesburg, VA 20176-2115 | 2010-05-20 |
| 1134305170 | Cynthia Creo Opatz Lombard | Nurse Practitioner | 601 E Dixie Ave Ste 401, Leesburg, FL 34748-5997 | 2008-01-20 |
| 1053536680 | Louise A Jones | Nurse Practitioner | 19450 Deerfield Ave Ste 325, Leesburg, VA 20176-8503 | 2007-04-17 |
| 1881760510 | Andrea M Macdonald | Nurse Practitioner | 2000 Edgewood Avenue, Leesburg, FL 34748 | 2006-11-27 |
| 1003884453 | Lino Lopez | Nurse Practitioner | 550 E. Dixie Avenue, Lrmc Urgent Care, Leesburg, FL 34748 | 2006-03-10 |
| 1346227899 | Shanna Carlee Greminger | Nurse Practitioner | 700 Fieldstone Dr Ne Ste 108-12, Endocrinology, Diabetes & Metabolism, Leesburg, VA 20176-4799 | 2005-12-27 |
| 1528045168 | Michael D Reilly | Nurse Practitioner | 2500 Citrus Blvd, Leesburg, FL 34748-3063 | 2005-12-26 |
| Find all providers in LEESBURG | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.