Donny Klay, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

11001332 Issued in FL

Practice address

1891 Beach Blvd
Jacksonville Beach, FL 32250-2644

Phone

(904) 249-3743

Fax

(904) 249-2047

NPI assigned

Sep 2, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Cleveland W. Randolph, Jr, MD, PAGroup PAC ID 5496749004, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: drrandolphsagelessandwellnessmedicalcenter.donnyklay@126165.advancedmd-direct.com

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.

• Cleveland W Randolph, Jr, MD, PA

  dba Dr. Randolph's Ageless & Wellness Medical Center

  • Specialist
  • Jacksonville Beach, FL
  • NPI 1497808182
  Medicare reassignment Care Compare group NPD
• Cleveland Randolph, Jr, MD, PA

  dba C.W.Randolph's Pharmacy

  • Pharmacy
  • Jacksonville Beach, FL
  • NPI 1629467782
  NPD (past)
• Quality Primary Care P a

  • Primary Care Clinic/Center
  • Jacksonville, FL
  • NPI 1245525518
  NPD (past)

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

{
    "created_epoch": "1441152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649808000000",
    "number": "1093183444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1891 BEACH BLVD",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322502644",
            "telephone_number": "904-249-3743",
            "fax_number": "904-249-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1891 BEACH BLVD",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322502644",
            "telephone_number": "904-249-3743",
            "fax_number": "904-249-2047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLAY",
        "first_name": "DONNY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-02",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9401504",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11001332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judith Ann Killeen, ARNP
• Aaron Kindsvatter, PH.D. LMHC
• Maxwell Clark King II, B.PH.
• Anneline Kingsley, M.D.
• Courtney Kirkham, COTA
• Douglas M Kleiner, ATC
• Jennifer Leigh Knight, M.D.
• Donna M Knox, LMT
• Andrew William Koenig, PT, DPT, OCS, CSCS
• Rachel Hoover Koenig, BCBA

• Nurse Practitioner in Jacksonville Beach, FL
• Providers in Jacksonville Beach, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.