Individual provider Active NPI

Katrina Kesterson

  • Psychiatry Physician
  • Orlando, FL
National Provider Identifier
1013401009
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME156233 Issued in FL
Practice address
4700 Millenia Blvd Ste 175
Orlando, FL 32839-6015
Phone
(407) 477-4060
NPI assigned
Jun 21, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X ME156233 FL Primary

Addresses

Primary practice location

4700 Millenia Blvd Ste 175
Orlando, FL 32839-6015

Mailing address

4700 Millenia Blvd Ste 175
Orlando, FL 32839-6015
Phone (407) 477-4060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Previously, effective Sep 7, 2024 through Sep 7, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
ME156233FLMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inlight Psychiatry PLLC Psychiatry Current Accepting new patients

Locations

4700 Millenia Blvd
Ste 175
Orlando, FL 32839
Phone (321) 332-7100

Interoperability endpoints

  • Direct secure messaging: katrina.kesterson@hca4.eclinicaldirectplus.com

Organizations & group practices 1

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": "1529539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1013401009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 MILLENIA BLVD STE 175",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328396015",
            "telephone_number": "407-477-4060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 MILLENIA BLVD STE 175",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328396015",
            "telephone_number": "407-477-4060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KESTERSON",
        "first_name": "KATRINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-21",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME156233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.