Individual provider Active NPI

Kelly Kathleen Nye

  • Adult Health Nurse Practitioner
  • Brandon, FL
National Provider Identifier
1174916555
Registry record updated Apr 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
ARNP 9253210 Issued in FL
Practice address
635 Eichenfeld Dr
Brandon, FL 33511-5908
Phone
(813) 767-9142
NPI assigned
Mar 10, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X ARNP 9253210 FL Primary

Addresses

Primary practice location

635 Eichenfeld Dr
Brandon, FL 33511-5908

Mailing address

635 Eichenfeld Dr
Brandon, FL 33511-5908
Phone (813) 684-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ARNP 9253210FLMDAdult Health Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: knye623427@adventhealth.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1425945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524441600000",
    "number": "1174916555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 EICHENFELD DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115908",
            "telephone_number": "813-684-6000",
            "fax_number": "813-685-1131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 EICHENFELD DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115908",
            "telephone_number": "813-767-9142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYE",
        "first_name": "KELLY",
        "middle_name": "KATHLEEN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-10",
        "last_updated": "2018-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP 9253210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.