Individual provider Active NPI

Kelli Bunn Fletcher, ARNP

  • Pediatric Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1003292129
Registry record updated Apr 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
APRN3189652 Issued in FL
Practice address
92 W Miller St
Orlando, FL 32806-2032
Phone
(321) 841-5104
Fax
(321) 841-6871
NPI assigned
Jul 31, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Pediatric Nurse Practitioner 363LP0222X 3189652 FL
Pediatric Nurse Practitioner 363LP0200X APRN3189652 FL Primary

Addresses

Primary practice location

92 W Miller St
Orlando, FL 32806-2032

Mailing address

92 W Miller St
Orlando, FL 32806-2032
Phone (321) 841-5104

Other identifiers 1

IdentifierTypeStateIssuer
126044300MedicaidFL

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250319002726 FL Practitioner - Nurse Practitioner 8123540127 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

92 W Miller St
Orlando, FL 32806-2032
Phone (321) 841-4607

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN3189652FLMDPediatric Nurse Practitioner
3189652FLMDCritical Care Pediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc CurrentSince Mar 1, 2025 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Mar 1, 2025 Accepting new patients
Orlando Health, Inc. Current Accepting new patients

Locations

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

92 W Miller St
Orlando, FL 32806
Phone (321) 841-4607

Interoperability endpoints

  • Direct secure messaging: kfletcher27794@orlandohealth.medalliesdirect.net

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1438300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743638400000",
    "number": "1003292129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 W MILLER ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062032",
            "telephone_number": "321-841-5104",
            "fax_number": "321-841-6871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 W MILLER ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062032",
            "telephone_number": "321-841-5104",
            "fax_number": "321-841-6871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLETCHER",
        "first_name": "KELLI",
        "middle_name": "BUNN",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-31",
        "last_updated": "2025-04-03",
        "certification_date": "2025-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0222X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics, Critical Care",
            "state": "FL",
            "license": "3189652",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "APRN3189652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "126044300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.