Individual provider Active NPI

Keira Randall, NP

  • Adult Health Nurse Practitioner
  • St Petersburg, FL
National Provider Identifier
1003658428
Registry record updated Mar 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
11033257 Issued in FL
Practice address
7901 4TH St N # 28048
St Petersburg, FL 33702-4305
Phone
(352) 596-1339
NPI assigned
Jun 7, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 11033257 FL Primary

Addresses

Primary practice location

7901 4TH St N # 28048
St Petersburg, FL 33702-4305

Mailing address

37689 Leafside LN
Zephyrhills, FL 33541-3804
Phone (813) 606-8110

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
I20250501002955 FL Practitioner - Nurse Practitioner 2365968369 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11033257FLMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fitmate Medical Group P.a. CurrentSince Aug 14, 2025 Accepting new patients
Keira Baker SKN Wellness Adult Health Current Accepting new patients
Keti Medical Center & Pain Management Inc CurrentSince Jun 9, 2024 Accepting new patients

Locations

2627 Hanover St
Palo Alto, CA 94304
Phone (979) 366-3564

7105 Mariner Blvd
Spring Hill, FL 34609
Phone (352) 585-3063

115 N Calhoun St
Ste 4
Tallahassee, FL 32301
Phone (323) 776-3632

502 W 7th St
Ste 100
Erie, PA 16502
Phone (215) 258-4243

5900 Balcones Dr
Ste 100
Austin, TX 78731

Interoperability endpoints

  • Direct secure messaging: keira.randall.1@25403.direct.athenahealth.com

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": "1717718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773360000000",
    "number": "1003658428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37689 LEAFSIDE LN",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335413804",
            "telephone_number": "813-606-8110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 4TH ST N # 28048",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337024305",
            "telephone_number": "352-596-1339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "KEIRA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-07",
        "last_updated": "2026-03-13",
        "certification_date": "2026-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "11033257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.