Active NPI
Kendra Lawrence, NURSE PRACTITIONER
- Nurse Practitioner
- Fort Walton Beach, FL
National Provider Identifier
1114450418
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 11002506
- Practice address
- 1992 Lewis Turner Blvd
Fort Walton Beach, FL 32547-1255 - Phone
- (888) 732-3452
- NPI assigned
- Apr 4, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | AP133602 | TX | |
| Acute Care Nurse Practitioner | 363LA2100X | AP133602 | TX | |
| Adult Health Nurse Practitioner | 363LA2200X | AP133602 | TX | |
| Nurse Practitioner | 363L00000X | 11002506 | FL | Primary |
| Adult Medicine Physician | 207QA0505X | 11002506 | FL | |
| Geriatric Medicine (Family Medicine) Physician | 207QG0300X | 11002506 | FL | |
| Internal Medicine Physician | 207R00000X | 11002506 | FL |
Addresses
Primary practice location
1992 Lewis Turner Blvd
Fort Walton Beach, FL 32547-1255
Mailing address
495 Grand Blvd Ste 206
Miramar Beach, FL 32550-1897
Phone (888) 732-3452
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
400 E Rivulon Blvd
Gilbert, AZ 85297-0096
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11002506 | FL | MD | Geriatric Medicine (Family Medicine) Physician |
| AP133602 | TX | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tecs FL PA | Current | Accepting new patients |
Locations
4875 Cason Cove Dr
Orlando, FL 32811
Phone (386) 344-1538
18312 Middlebelt Rd
Livonia, MI 48152
Phone (248) 426-9944
Interoperability endpoints
- kendra.lawrence.p1@direct.alegiscare.nextgenshare.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.
-
- Physical Medicine & Rehabilitation Physician
- Orlando, FL
- NPI 1477341220
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1491264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712102400000",
"number": "1114450418",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "495 GRAND BLVD STE 206",
"city": "MIRAMAR BEACH",
"state": "FL",
"postal_code": "325501897",
"telephone_number": "888-732-3452"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1992 LEWIS TURNER BLVD",
"city": "FORT WALTON BEACH",
"state": "FL",
"postal_code": "325471255",
"telephone_number": "888-732-3452"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAWRENCE",
"first_name": "KENDRA",
"credential": "NURSE PRACTITIONER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-04-04",
"last_updated": "2024-04-03",
"certification_date": "2024-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "TX",
"license": "AP133602",
"primary": false
},
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "TX",
"license": "AP133602",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "TX",
"license": "AP133602",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "FL",
"license": "11002506",
"primary": true
},
{
"code": "207QA0505X",
"taxonomy_group": "",
"desc": "Family Medicine, Adult Medicine",
"state": "FL",
"license": "11002506",
"primary": false
},
{
"code": "207QG0300X",
"taxonomy_group": "",
"desc": "Family Medicine, Geriatric Medicine",
"state": "FL",
"license": "11002506",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "11002506",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Walton Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2024; 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.