Individual provider Active NPI

Kathryn Anne Tuttle, FNP-C

  • Family Nurse Practitioner
  • Fort Myers, FL
National Provider Identifier
1154956977
Registry record updated Feb 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11012865 Issued in FL
Practice address
13774 Plantation Rd Ste 100
Fort Myers, FL 33912-4461
Phone
(239) 236-7777
Fax
(239) 245-7028
NPI assigned
Mar 12, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11012865 FL Primary
Family Nurse Practitioner 363LF0000X 28197550A IN

Addresses

Primary practice location

13774 Plantation Rd Ste 100
Fort Myers, FL 33912-4461

Mailing address

2675 Winkler Ave FL 2
Fort Myers, FL 33901-9342
Phone (877) 856-3774

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, 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
I20200622002713 IN Practitioner - Nurse Practitioner 7416379367 Reassigns benefits to 1 organization
I20210730002180 FL Practitioner - Nurse Practitioner 7416379367 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians

Practice addresses (Care Compare)

13774 Plantation Rd
Suite 100
Fort Myers, FL 33912-4461
Phone (239) 349-3539

Hospital & facility affiliations

  • Cape Coral Hospital Hospital, Cape Coral, FL, CCN 100244
  • Lee Memorial Hospital Hospital, Fort Myers, FL, CCN 100012

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11012865FLMDFamily Nurse Practitioner
28197550AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Physician Group LLC CurrentSince Aug 23, 2021 Accepting new patients
Oliver Family Healthcare PC Family CurrentSince Apr 1, 2020 Accepting new patients
Millennium Physician Group LLC CurrentSince Aug 23, 2021 Accepting new patients
Eagle Creek Urgent Care LLC PastSince Mar 1, 2020 Accepting new patients

Locations

13774 Plantation Rd
Ste 100
Fort Myers, FL 33912
Phone (239) 236-7777

2675 Winkler Ave
Fl 2
Fort Myers, FL 33901
Phone (855) 979-5700

3434 Hancock Bridge Pkwy
Ste 301
North Ft Myers, FL 33903
Phone 877856377411108

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

5645 Lafayette Rd
Ste B
Indianapolis, IN 46254
Phone (317) 387-3050

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: kathryn.tuttle.1@4290.direct.athenahealth.com

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 2

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": "1583971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1154956977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "877-856-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13774 PLANTATION RD STE 100",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124461",
            "telephone_number": "239-236-7777",
            "fax_number": "239-245-7028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUTTLE",
        "first_name": "KATHRYN",
        "middle_name": "ANNE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-12",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11012865",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28197550A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.