Individual provider Active NPI

Kathryn Marie Marple, PA-C

  • Physician Assistant
  • Aventura, FL
National Provider Identifier
1194021923
Registry record updated Dec 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9105858 Issued in FL
Practice address
21000 NE 28TH Ave Ste 104
Aventura, FL 33180-1421
Phone
(305) 933-0626
NPI assigned
Jan 26, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9105858 FL Primary

Addresses

Primary practice location

21000 NE 28TH Ave Ste 104
Aventura, FL 33180-1421

Mailing address

7300 SW 18TH St
Plantation, FL 33317-4913
Phone (954) 465-9395

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
I20111003000488 FL Practitioner - Physician Assistant 8628240207 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9105858FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cleveland Clinic Florida a Nonprofit Corporation CurrentSince May 10, 2015 Accepting new patients
FL-I Medical Services, LLC Physician Assistant CurrentSince Jan 20, 2015 Accepting new patients

Locations

1700 S 23rd St
Fort Pierce, FL 34950
Phone (772) 461-4000

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

2950 Cleveland Clinic Blvd
Weston, FL 33331
Phone (954) 689-5000

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": "1296000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1194021923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 SW 18TH ST",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333174913",
            "telephone_number": "954-465-9395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21000 NE 28TH AVE STE 104",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331801421",
            "telephone_number": "305-933-0626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARPLE",
        "first_name": "KATHRYN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-26",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9105858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aventura, FL

Sources for this page

Verify at the official NPI Registry.