GERIATRIC PROVIDERS LLC (NPI# 1801225875) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801225875 |
| Entity Type | Organization |
| Organization Name | GERIATRIC PROVIDERS LLC |
| Practice Address |
3838 Northlake Blvd Palm Beach Gardens FL 33403-1535 |
| Practice Telephone | 5615574728 |
| Practice Fax Number | 8553440366 |
| Mailing Telephone | 5615574728 |
| Mailing Fax Number | 8553440366 |
| Enumeration Date | 2013-11-11 |
| Last Update Date | 2013-11-11 |
| Authorized Official Name | DINAKAR KOTIYAN (ADMINISTRATOR) |
| Authorized Official Telephone | 5615574728 |
| Authorized Official Credential | NP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | NONE | L13000153711 | 01 |
| Street Address |
3838 NORTHLAKE BLVD |
| City | PALM BEACH GARDENS |
| State | FL |
| Zip Code | 33403-1535 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396391355 | Brittany Oclon | Physical Therapist | 3450 Northlake Blvd., Suite 101, Palm Beach Gardens, FL 33403 | 2019-08-15 |
| 1558836668 | Daniel Patirck Harrison | Nurse Practitioner | 903 Lake Shore Drive, Apt. 102, West Palm Beach, FL 33403 | 2018-10-04 |
| 1073099453 | Lashunda Blackshear | Nurse Practitioner | 538 Cypress Drive, Lake Park, FL 33403 | 2018-07-18 |
| 1659864049 | Tara E Turene | Behavior Technician | 900 Burma Road, Suit 109, Palm Beach Gardens, FL 33403 | 2018-06-11 |
| 1437672748 | Reasons for Change, LLC | Community Based Residential Treatment Facility, Mental Illness | 143 Silver Beach Road, Lake Park, FL 33403 | 2017-07-18 |
| 1427587815 | Kristin Barahona | Behavioral Analyst | 9000 Burma Road Suite 109, Palm Beach Gardens, FL 33403 | 2017-06-08 |
| 1497284855 | Brigitte Mallary Toledo | Behavioral Analyst | 9000 Burma Road, Suite 109, Palm Beach Gardens, FL 33403 | 2017-06-08 |
| 1568914539 | Daniel & Max, LLC | Optometrist | 3331 Northlake Blvd, Suite 1, Palm Beach Gardens, FL 33403 | 2016-10-26 |
| 1144778028 | Griffee Dental I Pa | Dentist | 3333 Northlake Blvd, Ste 6, Palm Beach Gardens, FL 33403 | 2016-09-20 |
| 1982158929 | Academy Whole Health Solutions | Substance Abuse Rehabilitation Facility | 504 10th St, Lake Park, FL 33403 | 2016-08-08 |
| Find all providers in zip 33403 | ||||
| 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 |
|---|---|---|---|---|
| 1669095824 | Jaime Marie Johns | Nurse Practitioner | 4777 Square Lake Dr, Palm Beach Gardens, FL 33418-6151 | 2020-05-22 |
| 1538658125 | Erin Rebecca Rathjen | Nurse Practitioner | 3365 Burns Rd Ste 101, Palm Beach Gardens, FL 33410-4302 | 2018-05-09 |
| 1558766337 | Stephanie Montes Vega | Nurse Practitioner | 3401 Pga Blvd Ste 400, Palm Beach Gardens, FL 33410-2825 | 2014-10-23 |
| 1710324330 | Timothy Yarbrough | Nurse Practitioner | 5568 Golden Eagle Cir, Palm Beach Gardens, FL 33418-1523 | 2013-05-23 |
| 1821054024 | Melissa Lyn Kilian | Nurse Practitioner | 3370 Burns Rd Ste 103, Palm Beach Gardens, FL 33410-4327 | 2006-04-25 |
| 1417583147 | Katy Redfield | Nurse Practitioner | 11000 Prosperity Farms Rd, Palm Beach Gardens, FL 33410-3462 | 2020-03-13 |
| 1235773029 | Judy Rose Barrett | Nurse Practitioner | 3385 Burns Rd Ste 106, Palm Beach Gardens, FL 33410-4328 | 2019-11-04 |
| 1013562735 | Comprehensive Wound Management LLC | Nurse Practitioner | 4346 Daffodil Cir S, Palm Beach Gardens, FL 33410-5417 | 2019-08-08 |
| 1205305778 | Debbie Andrea Saiovici | Nurse Practitioner | 3401 Pga Blvd, Palm Beach Gardens, FL 33410-2823 | 2018-11-14 |
| 1417442989 | Karina B Shepard | Nurse Practitioner | 900 Village Square Xing Ste 170, Palm Beach Gardens, FL 33410-4549 | 2018-06-27 |
| Find all providers in PALM BEACH GARDENS | ||||
| City | PALM BEACH GARDENS |
| Zip Code | 33403 |
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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.