Individual provider Active NPI

Kettelene Philogene McMorris, APRN

  • Nurse Practitioner
  • Port Saint Lucie, FL
National Provider Identifier
1194342048
Registry record updated Jul 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN2374100 Issued in MA
Practice address
10000 SW Innovation Way
Port Saint Lucie, FL 34987-2111
Phone
(772) 345-8100
NPI assigned
Jun 26, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2026

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

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 350474 NY
Family Nurse Practitioner 363LF0000X APRN11007657 FL
Registered Nurse 163W00000X RN9309679 FL
Nurse Practitioner 363L00000X 4704451405 MI
Nurse Practitioner 363L00000X 40756 TN
Nurse Practitioner 363L00000X 5023205 NC
Nurse Practitioner 363L00000X RN2374100 MA Primary
Nurse Practitioner 363L00000X C-APN-0004597-C-NP CO
Nurse Practitioner 363L00000X 277.005077 IL
Nurse Practitioner 363L00000X 17052 CT
Nurse Practitioner 363L00000X 88570 NM
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11007657 FL
Nurse Practitioner 363L00000X 10057847 OR
Nurse Practitioner 363L00000X 118367-23 NH
Nurse Practitioner 363L00000X 26NJ14912700 NJ

Addresses

Primary practice location

10000 SW Innovation Way
Port Saint Lucie, FL 34987-2111

Mailing address

1860 SW Fountainview Blvd Ste 100
Port Saint Lucie, FL 34986-4528
Phone (754) 366-1406

Other practice location 1

200 SE Hospital Ave
Stuart, FL 34994-2346
Phone (772) 287-5200

Other practice location 2

1860 SW Fountainview Blvd Ste 100
Port Saint Lucie, FL 34986-4528
Phone (772) 207-4900 ext. 61406

Other practice location 3

1350 Hickory St
Melbourne, FL 32901-3224
Phone (321) 433-4225

Other practice location 4

1000 36th St
Vero Beach, FL 32960-4862
Phone (772) 567-4311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, MA, NY, TN, WA5 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 5

Enrollment IDStateProvider typePAC IDDetails
I20210218000110 FL Practitioner - Nurse Practitioner 7719392158 Reassigns benefits to 2 organizations
I20230921003789 MA Practitioner - Nurse Practitioner 7719392158 Reassigns benefits to 3 organizations
I20240502001654 NY Practitioner - Nurse Practitioner 7719392158 Reassigns benefits to 1 organization
I20260423000537 TN Practitioner - Nurse Practitioner 7719392158 Reassigns benefits to 1 organization
I20260521001105 WA Practitioner - Nurse Practitioner 7719392158 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2026
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York Medical Physician Associates PCGroup PAC ID 6709226350, 208 clinicians
Physicians of Cape Cod HospitalGroup PAC ID 9638326671, 330 clinicians
Methodist Inpatient Physicians LLCGroup PAC ID 1254241235, 123 clinicians
Apogee Medical Group, Florida IncGroup PAC ID 4082878509, 94 clinicians

Practice addresses (Care Compare)

241 N Rd
Poughkeepsie, NY 12601-1154
Phone (845) 483-5000

27 Park St
Hyannis, MA 02601-5230
Phone (774) 552-6000

7691 Poplar Ave
Germantown, TN 38138-3904
Phone (901) 516-1290

951 N Washington Ave
Titusville, FL 32796-2194
Phone (321) 268-6111

Hospital & facility affiliations

  • Wynn Hospital Hospital, Utica, NY, CCN 330044
  • Methodist Hospitals of Memphis Hospital, Memphis, TN, CCN 440049
  • Westchester Medical Center Hospital, Valhalla, NY, CCN 330234
  • St Josephs Hospital Hospital, Tampa, FL, CCN 100075
  • Cape Cod Hospital Hospital, Hyannis, MA, CCN 220012

Merit-based Incentive Payment System (MIPS)

Final score
92.26 of 100Reported as apm
Quality
80.2
Promoting interoperability
99.24
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
92.26 of 100Reported as apm
Quality
80.2
Promoting interoperability
99.24
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN9309679FLMDRegistered Nurse
350474NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Indian River Health Services Inc CurrentSince Feb 11, 2021 Accepting new patients
Physicians of Cape Cod Hospital CurrentSince May 1, 2025 Accepting new patients
Indian River Health Services Inc CurrentSince Feb 11, 2021 Accepting new patients
New York Medical Physician Associates PC CurrentSince May 7, 2024 Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince Jul 29, 2024 Accepting new patients
New York Medical Physician Associates PC CurrentSince May 7, 2024 Accepting new patients
Umass Memorial Medical Group Inc Nurse Practitioner Current Accepting new patients
New York Medical Physician Associates PC Current Accepting new patients
Apogee Medical Group, Florida Inc CurrentSince Dec 1, 2025 Accepting new patients
Marlborough Hospitalist Group, PLLC CurrentSince Aug 1, 2023 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

10000 SW Innovation Way
Port St Lucie, FL 34987
Phone (772) 288-5853

200 SE Hospital Ave
Stuart, FL 34994
Phone (772) 223-5618

2100 SE Salerno Rd
Stuart, FL 34997
Phone (772) 223-2300

951 N Washington Ave
Titusville, FL 32796
Phone (302) 325-5511

1190 37th St
Vero Beach, FL 32960
Phone (772) 563-4666

1000 36th St
Ste 5105
Vero Beach, FL 32960

1000 36th St
Vero Beach, FL 32960
Phone (772) 567-1942

27 Park St
Hyannis, MA 02601
Phone (508) 775-5011

157 Union St
Marlborough, MA 01752
Phone (508) 481-5000

119 Belmont St
Worcester, MA 01605
Phone (508) 334-6345

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

241 North Rd
Poughkeepsie, NY 12601
Phone (845) 431-8889

111 Hospital Dr
Utica, NY 13502
Phone (315) 801-8534

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 12

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 8

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": "1593129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784937600000",
    "number": "1194342048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 SW FOUNTAINVIEW BLVD STE 100",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349864528",
            "telephone_number": "754-366-1406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 SW INNOVATION WAY",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349872111",
            "telephone_number": "772-345-8100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 SE Hospital Ave",
            "address_purpose": "LOCATION",
            "city": "Stuart",
            "state": "FL",
            "postal_code": "349942346",
            "country_code": "US",
            "telephone_number": "772-287-5200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1860 SW Fountainview Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Port Saint Lucie",
            "state": "FL",
            "postal_code": "349864528",
            "country_code": "US",
            "telephone_number": "772-207-4900 x61406",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1350 Hickory St",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329013224",
            "country_code": "US",
            "telephone_number": "321-433-4225",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 36th St",
            "address_purpose": "LOCATION",
            "city": "Vero Beach",
            "state": "FL",
            "postal_code": "329604862",
            "country_code": "US",
            "telephone_number": "772-567-4311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCMORRIS",
        "first_name": "KETTELENE",
        "middle_name": "PHILOGENE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-26",
        "last_updated": "2026-07-25",
        "certification_date": "2026-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "350474",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11007657",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9309679",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704451405",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "40756",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5023205",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2374100",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "C-APN-0004597-C-NP",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "277.005077",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "17052",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NM",
            "license": "88570",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11007657",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "10057847",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NH",
            "license": "118367-23",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ14912700",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

Verify at the official NPI Registry.