Individual provider Active NPI

Kathryn Slott Villano, MD

  • Maternal & Fetal Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1104986892
Registry record updated May 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
License
ME 95466 Issued in FL
Practice address
836 Prudential Dr
Suite #1800
Jacksonville, FL 32207-8334
Phone
(904) 398-7684
Fax
(904) 398-4998
NPI assigned
Dec 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine Physician 207VM0101X ME 95466 FL Primary

Addresses

Primary practice location

836 Prudential Dr
Suite #1800
Jacksonville, FL 32207-8334

Mailing address

1500 Concord Ter
Sunrise, FL 33323-2815
Phone (800) 243-3839

Other identifiers 1

IdentifierTypeStateIssuer
001479500MedicaidFL

Other names 1

  • Kathryn Stanley Slott Former name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091016000478 FL Practitioner - Obstetrics/Gynecology 2163529744 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Medical University of South Carolina College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pediatrix Medical Group of Florida IncGroup PAC ID 4486634417, 37 clinicians

Practice addresses (Care Compare)

13241 Bartram Park Blvd
Unit 1017
Jacksonville, FL 32258-5234
Phone (904) 423-2670

3030 W Dr Martin Luther King Jr Blvd
Suite 201
Tampa, FL 33607-6308
Phone (813) 879-4730

3030 W Dr MLK Jr Blvd
Tampa, FL 33607-6308
Phone (813) 870-4000

3625 University S Blvd
Jacksonville, FL 32216-4207
Phone (904) 399-6111

800 Prudential Dr
Jacksonville, FL 32207-8202
Phone (904) 202-2902

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME 95466FLMDMaternal & Fetal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Halifax Healthcare Systems Inc CurrentSince Feb 22, 2010 Accepting new patients
Pediatrix Medical Group of Florida Inc Maternal & Fetal Medicine CurrentSince Aug 1, 2009 Accepting new patients
Camden OBGYN PastSince Jan 6, 2012 Accepting new patients

Locations

303 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 425-2285

836 Prudential Dr
Ste 1800
Jacksonville, FL 32207
Phone (904) 398-7684

13241 Bartram Park Blvd
Unit 1017
Jacksonville, FL 32258
Phone (904) 260-2001

3100 SW 62nd Ave
Miami, FL 33155
Phone (305) 669-5873

1901 SW 172nd Ave
Miramar, FL 33029
Phone (954) 276-5401

12969 S US 301
Riverview, FL 33578
Phone (813) 971-6909

1300 Sawgrs Corp Pkwy
Ste 200
Sunrise, FL 33323
Phone (954) 384-0175

3030 W Mlk Blvd
Tampa, FL 33607
Phone (813) 870-4000

202 Lakeshore Dr
Ste B
Saint Marys, GA 31558
Phone (912) 673-1771

202 Lakeshore Dr
Ste A
Saint Marys, GA 31558
Phone (912) 510-3454

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494288000000",
    "number": "1104986892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 CONCORD TER",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232815",
            "telephone_number": "800-243-3839",
            "fax_number": "855-527-5510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 PRUDENTIAL DR",
            "address_2": "SUITE #1800",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078334",
            "telephone_number": "904-398-7684",
            "fax_number": "904-398-4998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLANO",
        "first_name": "KATHRYN",
        "middle_name": "SLOTT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2017-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "FL",
            "license": "ME 95466",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001479500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "SLOTT",
            "middle_name": "STANLEY",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.