Individual provider Active NPI

Kelly Auclair, APRN

  • Family Nurse Practitioner
  • St Augustine, FL
National Provider Identifier
1013898758
Registry record updated Oct 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11041885 Issued in FL
Practice address
316 Paseo Reyes Dr
St Augustine, FL 32095-8464
Phone
(903) 544-5800
Fax
(903) 544-5800
NPI assigned
Sep 9, 2025
Last updated
Oct 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11041885 FL Primary

Addresses

Primary practice location

316 Paseo Reyes Dr
St Augustine, FL 32095-8464

Mailing address

316 Paseo Reyes Dr
St Augustine, FL 32095-8464

Other names 1

  • Kelly Zona Former name

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
I20251112001681 FL Practitioner - Nurse Practitioner 5092206656 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bold City Dermatology LLCGroup PAC ID 2769897974, 4 clinicians

Practice addresses (Care Compare)

316 Paseo Reyes Dr
St Augustine, FL 32095-8464
Phone (904) 544-5800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN11041885FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bold City Dermatology LLC CurrentSince Oct 1, 2025 Accepting new patients

Locations

120 Gateway Cir
Saint Johns, FL 32259
Phone (904) 252-4235

120 Gateway Cir
Unit 1
Saint Johns, FL 32259
Phone (904) 824-4407

316 Paseo Reyes Dr
St Augustine, FL 32095
Phone (904) 342-0219

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1757376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759795200000",
    "number": "1013898758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 PASEO REYES DR",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320958464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 PASEO REYES DR",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320958464",
            "telephone_number": "903-544-5800",
            "fax_number": "903-544-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUCLAIR",
        "first_name": "KELLY",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-09",
        "last_updated": "2025-10-07",
        "certification_date": "2025-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11041885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "ZONA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.