Individual provider Active NPI

Stephanie Renee Dove, FNP-C

  • Family Nurse Practitioner
  • Kissimmee, FL
National Provider Identifier
1205490059
Registry record updated Jun 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11030674 Issued in FL
Practice address
2651 Ham Brown Rd
Kissimmee, FL 34746-3415
Phone
(407) 452-1025
Fax
(407) 452-1068
NPI assigned
Apr 26, 2019
Last updated
Jun 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11030674 FL Primary
Primary Care Nurse Practitioner 363LP2300X 11030674 FL

Addresses

Primary practice location

2651 Ham Brown Rd
Kissimmee, FL 34746-3415

Mailing address

PO Box 626
Loughman, FL 33858-0626
Phone (720) 737-1668

Other practice location 1

35600 US Hwy 27 N
Haines City, FL 33844-3731
Phone (863) 777-2899

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, FL2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20230417001241 CO Practitioner - Nurse Practitioner 4688049018 Reassigns benefits to 1 organization
I20250213000989 FL Practitioner - Nurse Practitioner 4688049018 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

35600 US Hwy 27 N
Haines City, FL 33844-3731
Phone (863) 777-2899

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11030674FLMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Denver, LLC Current Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Apr 24, 2023 Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Apr 24, 2023 Accepting new patients
Dove Medical Clinic LLC CurrentSince Feb 11, 2025 Accepting new patients
Premise Health of Florida Medical PA PastSince Oct 1, 2024 Accepting new patients
Lifehealth LLC Past Accepting new patients

Locations

500 Eldorado Blvd
Ste 4300
Broomfield, CO 80021

35600 US Hwy 27 N
Haines City, FL 33844
Phone (689) 241-0939

511 Ronald Reagan Pkwy
Unit 626
Loughman, FL 33858

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1556236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1205490059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 626",
            "city": "LOUGHMAN",
            "state": "FL",
            "postal_code": "338580626",
            "telephone_number": "720-737-1668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2651 HAM BROWN RD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347463415",
            "telephone_number": "407-452-1025",
            "fax_number": "407-452-1068"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "35600 US Hwy 27 N",
            "address_purpose": "LOCATION",
            "city": "Haines City",
            "state": "FL",
            "postal_code": "338443731",
            "country_code": "US",
            "telephone_number": "863-777-2899",
            "fax_number": "863-594-1631",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOVE",
        "first_name": "STEPHANIE",
        "middle_name": "RENEE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-26",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11030674",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "11030674",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.