Individual provider Active NPI

Kahley Wampler, PA-C

  • Physician Assistant
  • Tampa, FL
National Provider Identifier
1053074831
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9117611 Issued in FL
Practice address
6919 N Dale Mabry Hwy Ste 200
Tampa, FL 33614-3972
Phone
(813) 933-3324
NPI assigned
Oct 18, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9117611 FL Primary

Addresses

Primary practice location

6919 N Dale Mabry Hwy Ste 200
Tampa, FL 33614-3972

Mailing address

6919 N Dale Mabry Hwy Ste 200
Tampa, FL 33614-3972
Phone (813) 933-3324

Other practice location 1

2502 W Saint Isabel St
Tampa, FL 33607-6318
Phone (813) 874-5707

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230120000066 CO Practitioner - Physician Assistant 7315318813 Reassigns benefits to 1 organization
I20240307004191 FL Practitioner - Physician Assistant 7315318813 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Florida Hospital Physician Group IncGroup PAC ID 2365679057, 953 clinicians

Practice addresses (Care Compare)

13901 Bruce B Downs Blvd
Tampa, FL 33613-3905
Phone (813) 615-7260

6919 N Dale Mabry Hwy
Suite 200
Tampa, FL 33614-3972
Phone (813) 933-3324

Hospital & facility affiliations

  • AdventHealth Carrollwood Hospital, Tampa, FL, CCN 100069
  • Adventhealth Tampa Hospital, Tampa, FL, CCN 100173

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9117611FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Center, LLC CurrentSince Jan 6, 2023 Accepting new patients
Family Care Center, LLC Physician Assistant CurrentSince Jan 6, 2023 Accepting new patients
Emergency Medical Associates of Tampa Bay, LLC PastSince Mar 1, 2024 Accepting new patients

Locations

2860 S Circle Dr
Fl 4
Colorado Springs, CO 80906
Phone (719) 540-2146

2860 S Circle Dr
Ste 109
Colorado Springs, CO 80906
Phone 71954021004002

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: kwampler3003238@adventhealth.direct-ci.com

Organizations & group practices 4

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 3

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": "1634515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1053074831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6919 N DALE MABRY HWY STE 200",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336143972",
            "telephone_number": "813-933-3324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6919 N DALE MABRY HWY STE 200",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336143972",
            "telephone_number": "813-933-3324"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2502 W Saint Isabel St",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336076318",
            "country_code": "US",
            "telephone_number": "813-874-5707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAMPLER",
        "first_name": "KAHLEY",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-18",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9117611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.