Individual provider Active NPI

Kayla Smith

  • Nurse Practitioner
  • Pensacola, FL
National Provider Identifier
1164003539
Registry record updated Oct 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11025288 Issued in FL
Practice address
1545 Airport Blvd Ste 2000
Pensacola, FL 32504-8615
Phone
(850) 416-6933
Fax
(850) 416-6934
NPI assigned
Apr 17, 2021
Last updated
Oct 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN11025288 FL Primary

Addresses

Primary practice location

1545 Airport Blvd Ste 2000
Pensacola, FL 32504-8615

Mailing address

4205 Belfort Rd Ste 4015
Jacksonville, FL 32216-3623
Phone (904) 450-6063

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
I20230831001834 FL Practitioner - Nurse Practitioner 2466815972 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11025288FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Heart Health System, Inc. CurrentSince Aug 21, 2023 Accepting new patients
Sacred Heart Health System Inc CurrentSince Aug 21, 2023 Accepting new patients
Sacred Heart Health System, Inc. Current Accepting new patients

Locations

4205 Belfort Rd
Ste 4015
Jacksonville, FL 32216
Phone (904) 296-5691

7334 Navarre Pkwy
Navarre, FL 32566
Phone (850) 416-2337

1545 Airport Blvd
#2000
Pensacola, FL 32504
Phone (850) 416-6933

1545 Airport Blvd
Ste 2000
Pensacola, FL 32504
Phone (850) 416-6933

5151 N 9th Ave
Pensacola, FL 32504
Phone (850) 202-4700

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1618617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1164003539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 BELFORT RD STE 4015",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163623",
            "telephone_number": "904-450-6063",
            "fax_number": "904-539-4091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1545 AIRPORT BLVD STE 2000",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048615",
            "telephone_number": "850-416-6933",
            "fax_number": "850-416-6934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KAYLA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-17",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11025288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.