Individual provider Active NPI

Kennedy A Edwards, BSN, RN, CCRN

  • Acute Care Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1154092781
Registry record updated Nov 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
APRN11039938 Issued in FL
Practice address
601 E Rollins St
Orlando, FL 32803-1248
Phone
(407) 303-7283
Fax
(407) 303-0347
NPI assigned
Sep 23, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1-166795 AL
Critical Care Medicine Registered Nurse 163WC0200X 1-1667795 AL
Acute Care Nurse Practitioner 363LA2100X APRN11039938 FL Primary

Addresses

Primary practice location

601 E Rollins St
Orlando, FL 32803-1248

Mailing address

2201 Seasons CT
Mobile, AL 36695-8392
Phone (318) 267-9678

Other practice location 1

1700 Spring Hill Ave Ste 100
Mobile, AL 36604-1416
Phone (251) 435-1200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20231023002496 AL Practitioner - Nurse Practitioner 5890141196 Reassigns benefits to 1 organization
I20251109000036 FL Practitioner - Nurse Practitioner 5890141196 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Imc-Diagnostic and Medical Clinic LLCGroup PAC ID 2860399623, 168 clinicians
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

1700 Springhill Ave
Suite 100
Mobile, AL 36604-1416
Phone (251) 435-1200

2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700

601 E Rollins St
Orlando, FL 32803-1248
Phone (407) 303-2570

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
1-1667795ALMDCritical Care Medicine Registered Nurse
APRN11039938FLMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Nov 17, 2025 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Nov 17, 2025 Accepting new patients
Imc-Diagnostic and Medical Clinic LLC CurrentSince Nov 1, 2023 Accepting new patients
Imc-Diagnostic and Medical Clinic LLC CurrentSince Nov 1, 2023 Accepting new patients

Locations

1700 Spring Hill Ave
Ste 100
Mobile, AL 36604

1725 Spring Hill Ave
Mobile, AL 36604
Phone (251) 435-1366

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

Organizations & group practices 4

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 4

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": "1632355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763424000000",
    "number": "1154092781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 SEASONS CT",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366958392",
            "telephone_number": "318-267-9678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E ROLLINS ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031248",
            "telephone_number": "407-303-7283",
            "fax_number": "407-303-0347"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 Spring Hill Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Mobile",
            "state": "AL",
            "postal_code": "366041416",
            "country_code": "US",
            "telephone_number": "251-435-1200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "KENNEDY",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "BSN, RN, CCRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-23",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AL",
            "license": "1-166795",
            "primary": false
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "AL",
            "license": "1-1667795",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "APRN11039938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.