Individual provider Active NPI

Katrina Dawn Kemp, PA-C

  • Physician Assistant
  • Brandon, FL
National Provider Identifier
1104944396
Registry record updated Aug 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9103347 Issued in FL
Practice address
1355 Providence Rd
Brandon, FL 33511-4885
Phone
(813) 651-4441
Fax
(813) 661-3374
NPI assigned
Mar 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9103347 FL
Physician Assistant 363A00000X PA9103347 FL Primary

Addresses

Primary practice location

1355 Providence Rd
Brandon, FL 33511-4885

Mailing address

PO Box 1192
Brandon, FL 33509-1192
Phone (813) 651-4441

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
I20060331000021 FL Practitioner - Physician Assistant 4183632250 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vipul Joshi, MD PAGroup PAC ID 3678507811, 7 clinicians

Practice addresses (Care Compare)

1355 Providence Rd
Brandon, FL 33511-4885
Phone (813) 651-4441

Hospital & facility affiliations

  • St Josephs Hospital Hospital, Tampa, FL, CCN 100075
  • HCA Florida South Shore Hospital Hospital, Sun City Center, FL, CCN 100259
  • Adventhealth Tampa Hospital, Tampa, FL, CCN 100173

Merit-based Incentive Payment System (MIPS)

Final score
95.45 of 100Reported as individual
Quality
83.62
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: katrina.kemp@baao.eclinicaldirectplus.com

Organizations & group practices 1

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 5

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": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409011200000",
    "number": "1104944396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1192",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335091192",
            "telephone_number": "813-651-4441",
            "fax_number": "813-661-3374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 PROVIDENCE RD",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335114885",
            "telephone_number": "813-651-4441",
            "fax_number": "813-661-3374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEMP",
        "first_name": "KATRINA",
        "middle_name": "DAWN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2014-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9103347",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9103347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.