Individual provider Active NPI

Caroline Gray McKee

  • Physician Assistant
  • Fernandina Beach, FL
National Provider Identifier
1073393971
Registry record updated Mar 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9119735 Issued in FL
Practice address
1348 S 18TH St Ste 200
Fernandina Beach, FL 32034-4785
Phone
(904) 202-6683
Fax
(904) 376-3062
NPI assigned
Sep 29, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2026

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 PA9119735 FL Primary

Addresses

Primary practice location

1348 S 18TH St Ste 200
Fernandina Beach, FL 32034-4785

Mailing address

PO Box 746647
Atlanta, GA 30374-6647
Phone (904) 202-2092

Other practice location 1

851042 US Highway 17 Ste A
Yulee, FL 32097-2845
Phone (904) 202-6683

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
I20260311003512 FL Practitioner - Physician Assistant 7416430087 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Mercy College, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lyerly Baptist IncGroup PAC ID 9830112226, 72 clinicians

Practice addresses (Care Compare)

1348 S 18TH St
Suite 200
Fernandina Beach, FL 32034-4785
Phone (904) 202-6683

Hospital & facility affiliations

  • Baptist Medical Center - Nassau Hospital, Fernandina Beach, FL, CCN 100140

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA9119735FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lyerly Baptist Inc CurrentSince Apr 2, 2026 Accepting new patients
Lyerly Baptist Inc Physician Assistant CurrentSince Apr 2, 2026 Accepting new patients

Locations

1348 S 18th St
Ste 200
Fernandina Beach, FL 32034
Phone (904) 202-6683

851042 US Highway 17
Yulee, FL 32097
Phone (904) 225-3824

851042 US Highway 17
Ste A
Yulee, FL 32097
Phone (904) 202-6683

Organizations & group practices 2

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 1

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": "1695945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772582400000",
    "number": "1073393971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746647",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746647",
            "telephone_number": "904-202-2092",
            "fax_number": "904-376-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1348 S 18TH ST STE 200",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320344785",
            "telephone_number": "904-202-6683",
            "fax_number": "904-376-3062"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "851042 US Highway 17 Ste A",
            "address_purpose": "LOCATION",
            "city": "Yulee",
            "state": "FL",
            "postal_code": "320972845",
            "country_code": "US",
            "telephone_number": "904-202-6683",
            "fax_number": "904-376-3062",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKEE",
        "first_name": "CAROLINE",
        "middle_name": "GRAY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-29",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9119735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fernandina Beach, FL

Sources for this page

Verify at the official NPI Registry.