Individual provider Active NPI

Kayla Michelle Pedonti

  • Nurse Practitioner
  • Port St Lucie, FL
National Provider Identifier
1194620690
Registry record updated Nov 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11051984 Issued in FL
Practice address
603 NE Canoe Park Cir
Port St Lucie, FL 34983-3526
Phone
(772) 475-1231
NPI assigned
Oct 13, 2026
Last updated
Nov 1, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11051984 FL Primary
Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163W00000X 9582365 FL

Addresses

Primary practice location

603 NE Canoe Park Cir
Port St Lucie, FL 34983-3526

Mailing address

603 NE Canoe Park Cir
Port St Lucie, FL 34983-3526
Phone (772) 475-1231

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1791849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1793491200000",
    "number": "1194620690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 NE CANOE PARK CIR",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349833526",
            "telephone_number": "772-475-1231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 NE CANOE PARK CIR",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349833526",
            "telephone_number": "772-475-1231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDONTI",
        "first_name": "KAYLA",
        "middle_name": "MICHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-10-13",
        "last_updated": "2026-11-01",
        "certification_date": "2026-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11051984",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9582365",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2026; 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.