Individual provider Active NPI

Kristen D'Aun Lockett-Putmon, APRN, FNP-C

  • Family Nurse Practitioner
  • Belle Glade, FL
National Provider Identifier
1205422383
Registry record updated Dec 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11005620 Issued in FL
Practice address
1508 NW Avenue D Apt B2
Belle Glade, FL 33430-2867
Phone
(561) 234-8165
NPI assigned
Dec 14, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 9358446 FL
Nurse Practitioner 363L00000X 11005620 FL
Family Nurse Practitioner 363LF0000X 11005620 FL Primary

Addresses

Primary practice location

1508 NW Avenue D Apt B2
Belle Glade, FL 33430-2867

Mailing address

1508 NW Avenue D Apt B2
Belle Glade, FL 33430-2867
Phone (561) 234-8165

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
I20220830000883 FL Practitioner - Nurse Practitioner 0749664449 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9358446FLMDRegistered Nurse
11005620FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Accountable Care Post Acute Care Services LLC CurrentSince Mar 19, 2024 Accepting new patients
Radial Health Southeast LLC CurrentSince May 6, 2025 Accepting new patients

Locations

674 Pioneer Rd
Jupiter, FL 33458
Phone (561) 485-0070

5301 S Congress Ave
Lantana, FL 33462
Phone (561) 548-3549

5555 W Blue Heron Blvd
Riviera Beach, FL 33418
Phone (561) 659-1000

10330 Nuvista Ave
Wellington, FL 33414
Phone (561) 598-5419

1155 S Congress Ave
Ste C
West Palm Beach, FL 33406
Phone 5617661300601

2939 S Haverhill Rd
West Palm Beach, FL 33415
Phone (561) 641-3130

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1607904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607904000000",
    "number": "1205422383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1508 NW AVENUE D APT B2",
            "city": "BELLE GLADE",
            "state": "FL",
            "postal_code": "334302867",
            "telephone_number": "561-234-8165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1508 NW AVENUE D APT B2",
            "city": "BELLE GLADE",
            "state": "FL",
            "postal_code": "334302867",
            "telephone_number": "561-234-8165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKETT-PUTMON",
        "first_name": "KRISTEN",
        "middle_name": "D'AUN",
        "name_prefix": "Mrs.",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-14",
        "last_updated": "2020-12-14",
        "certification_date": "2020-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9358446",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11005620",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11005620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belle Glade, FL

Sources for this page

Verify at the official NPI Registry.