Individual provider Active NPI

Kayla Welch

  • Family Nurse Practitioner
  • Perry, FL
National Provider Identifier
1104626696
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11038204 Issued in FL
Practice address
209 Judson Dr
Perry, FL 32348-4764
Phone
(772) 579-0377
NPI assigned
Mar 14, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 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 11038204 FL Primary

Addresses

Primary practice location

209 Judson Dr
Perry, FL 32348-4764

Mailing address

209 Judson Dr
Perry, FL 32348-4764

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11038204FLMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1741910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748908800000",
    "number": "1104626696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 JUDSON DR",
            "city": "PERRY",
            "state": "FL",
            "postal_code": "323484764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 JUDSON DR",
            "city": "PERRY",
            "state": "FL",
            "postal_code": "323484764",
            "telephone_number": "772-579-0377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELCH",
        "first_name": "KAYLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-14",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11038204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perry, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.