Kathleen McKenna Ruhlin Primm, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9109278 Issued in FL

Practice address

1887 Kingsley Ave. Suite 1900
Orange Park, FL 32073-1559

Phone

(904) 276-2549

Fax

(904) 276-9235

NPI assigned

Jul 11, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Florida Trauma Services LLCGroup PAC ID 3971985938, 92 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCA Florida Orange Park Hospital Hospital, Orange Park, FL, CCN 100226

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Florida Trauma Services, LLC

  • Trauma Surgery Physician
  • Fort Walton Beach, FL
  • NPI 1477296952
  Medicare reassignment Care Compare group

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

• Orange Park Medical Center, Inc.

  • General Acute Care Hospital
  • Orange Park, FL
  • NPI 1689611501
  Care Compare affiliation

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

{
    "created_epoch": "1373500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1104267749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1887 KINGSLEY AVE. SUITE 1900",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320731559",
            "telephone_number": "904-276-2549",
            "fax_number": "904-276-9235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1887 KINGSLEY AVE. SUITE 1900",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320731559",
            "telephone_number": "904-276-2549",
            "fax_number": "904-276-9235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUHLIN PRIMM",
        "first_name": "KATHLEEN",
        "middle_name": "MCKENNA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-11",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OH",
            "license": "50.003862",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9109278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0093695",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Royal Homemaker and Companion
• Donna Lee Royal, DNP, CRNA
• Abhijit Roychowdhury, MD
• Beethoven T Ruedas, M.D.
• J D Ruggiero, MD
• Johanna Ruiz, MD
• Ricardo Daniel Ruiz, DO
• Nicole Russ
• Alexandria Russell
• Pamela Russell, TH. D.

• Physician Assistant in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; 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.