Individual provider Active NPI

Kelly Melissa Roland, APRN

  • Family Nurse Practitioner
  • Fort Lauderdale, FL
National Provider Identifier
1013486729
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN9412186 Issued in FL
Practice address
1601 S Andrews Ave FL 3
Fort Lauderdale, FL 33316-2509
Phone
(954) 763-6655
Fax
(954) 763-6799
NPI assigned
Nov 26, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN9412186 FL Primary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 9412186 FL

Addresses

Primary practice location

1601 S Andrews Ave FL 3
Fort Lauderdale, FL 33316-2509

Mailing address

1700 NW 49TH St Ste 125
Fort Lauderdale, FL 33309-3750
Phone (954) 473-7642

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
I20211102001221 FL Practitioner - Nurse Practitioner 5496143919 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Broward Hospital DistrictGroup PAC ID 3577472422, 192 clinicians

Practice addresses (Care Compare)

1601 S Andrews Ave
FL 3
Fort Lauderdale, FL 33316-2509
Phone (954) 320-3304

Hospital & facility affiliations

  • Broward Health Medical Center Hospital, Fort Lauderdale, FL, CCN 100039
  • Broward Health Imperial Point Hospital, Fort Lauderdale, FL, CCN 100200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9412186FLMDFamily Nurse Practitioner
APRN9412186FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Broward Hospital District Single Specialty Current Accepting new patients
North Broward Hospital District Single Specialty CurrentSince Jan 22, 2024 Accepting new patients
North Broward Hospital District CurrentSince Jan 22, 2024 Accepting new patients
North Broward Hospital District Past Accepting new patients
North Broward Hospital District Past Accepting new patients

Locations

1700 NW 49th St
Ste 125
Ft Lauderdale, FL 33309
Phone (954) 355-3490

1601 S Andrews Ave
Fl 3
Ft Lauderdale, FL 33316
Phone (954) 320-3380

1625 SE 3rd Ave
Ft Lauderdale, FL 33316
Phone (954) 722-4950

12 NE 12th Ave
Ft Lauderdale, FL 33301
Phone (954) 463-3416

1600 S Andrews Ave
Ft Lauderdale, FL 33316
Phone (954) 355-4000

Networks

  • Freedom Health HMO Network

Organizations & group practices 5

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1543190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1013486729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 NW 49TH ST STE 125",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333093750",
            "telephone_number": "954-473-7642",
            "fax_number": "954-473-7686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 S ANDREWS AVE FL 3",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162509",
            "telephone_number": "954-763-6655",
            "fax_number": "954-763-6799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLAND",
        "first_name": "KELLY",
        "middle_name": "MELISSA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-26",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9412186",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9412186",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.