Individual provider Active NPI

Patricia Pauline Koerner, ARNP

  • Family Nurse Practitioner
  • New Smyrna Beach, FL
National Provider Identifier
1154870384
Registry record updated Jan 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN9187304 Issued in FL
Practice address
245 N Causeway
New Smyrna Beach, FL 32169-5239
Phone
(386) 426-5800
NPI assigned
Sep 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2020

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 RN9187304 FL Primary

Addresses

Primary practice location

245 N Causeway
New Smyrna Beach, FL 32169-5239

Mailing address

395 Trafalga Ave
Port Orange, FL 32127-5942
Phone (386) 864-0860

Other names 1

  • Ms. Patricia Pauline Dollieslager 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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170216001917 FL Practitioner - Nurse Practitioner 0840573879 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN9187304FLMDFamily Nurse Practitioner

Practice roles (4 of 5)

OrganizationSpecialtyStatusNew patients
Mobile Visiting Practitioners, LLC CurrentSince Jun 24, 2024 Accepting new patients
Behavioral Health Services of Florida LLC CurrentSince Jun 24, 2024 Accepting new patients
Dispatchhealth-Florida Inc. CurrentSince Jan 1, 2024 Accepting new patients
Dispatchhealth-Florida Inc. PastSince Aug 1, 2021 Accepting new patients

Locations

140 S Beach St
Ste 202
Daytona Beach, FL 32114
Phone (888) 506-8836

1440 N Nova Rd
Ste 305
Daytona Beach, FL 32117
Phone (386) 258-8680

7925 NW 12th St
Ste 129
Doral, FL 33126
Phone (786) 644-6413

8270 College Pkwy
Ste 103
Fort Myers, FL 33919
Phone (239) 322-3434

3200 SW 34th Ave
Ste 702
Ocala, FL 34474

5421 Beaumont Center Blvd
Ste 660
Tampa, FL 33634
Phone (813) 551-1015

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: patricia.koerner.1@13869.direct.athenahealth.com

Organizations & group practices 5

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": "1475107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580256000000",
    "number": "1154870384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395 TRAFALGA AVE",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321275942",
            "telephone_number": "386-864-0860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 N CAUSEWAY",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321695239",
            "telephone_number": "386-426-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOERNER",
        "first_name": "PATRICIA",
        "middle_name": "PAULINE",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-29",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "RN9187304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRICIA",
            "last_name": "DOLLIESLAGER",
            "middle_name": "PAULINE",
            "prefix": "MS.",
            "credential": "ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New Smyrna Beach, FL

Sources for this page

Verify at the official NPI Registry.