Kyle Hollingsworth, PA-C, ATC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

710 Lomax St
Jacksonville, FL 32204-4015

Phone

(904) 355-6583

NPI assigned

Jun 10, 2013

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

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

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Florida Physician Specialists LLCGroup PAC ID 4486806213, 37 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCA Florida Memorial Hospital Hospital, Jacksonville, FL, CCN 100179
• Ascension St Vincent'S Southside Hospital, Jacksonville, FL, CCN 100307
• Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088
• Baptist Medical Center Beaches Hospital, Jacksonville Beach, FL, CCN 100117
• Ascension St Vincent'S Riverside Hospital, Jacksonville, FL, CCN 100040

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Florida Physician Specialists LLC

  • Radiation Oncology Physician
  • Jacksonville, FL
  • NPI 1588917108
  Medicare reassignment Care Compare group NPD (past)
• Florida Physician Specialists LLC

  • Urology Physician
  • Jacksonville, FL
  • NPI 1083959563
  NPD
• Florida Physician Specialists LLC

  • Urology Physician
  • Jacksonville, FL
  • NPI 1619221637
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baptist Medical Center of the Beaches, Inc

  • General Acute Care Hospital
  • Jacksonville Beach, FL
  • NPI 1821155912
  Care Compare affiliation
• Memorial Healthcare Group Inc

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1447206438
  Care Compare affiliation
• Southern Baptist Hospital of Florida Inc

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1578620449
  Care Compare affiliation
• St Lukes - St Vincents Healthcare

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1396926747
  Care Compare affiliation
• St Vincents Medical Center Inc

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1134117575
  Care Compare affiliation
• St. Vincent'S Medical Center, Inc.

  • Clinical Medical Laboratory
  • Jacksonville, FL
  • NPI 1669556072

  Hospital

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1370822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568851200000",
    "number": "1003254228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13582 CAPISTRANO DR S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322243078",
            "telephone_number": "813-486-1430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 LOMAX ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044015",
            "telephone_number": "904-355-6583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLINGSWORTH",
        "first_name": "KYLE",
        "credential": "PA-C, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-10",
        "last_updated": "2019-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL3527",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Dale Hollenbach, ARNP
• Cynthia Renee Holliday, D.D.S.
• Tiffany Holliday
• Carolyn Hollingsworth
• Kaylea Hardin Hollingsworth, SLP
• Lindsey Beth Hollingsworth, PA-C
• Rachel Ann Hollingsworth
• Lori-Linell Colby Hollins, M.D.
• Berinda Hollis-Sapp
• Natalie J Hollis, APRN

• Physician Assistant in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.