Individual provider Active NPI

Lauren McKiernan, PA-C

  • Physician Assistant
  • Celebration, FL
National Provider Identifier
1255784872
Registry record updated Sep 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9110380 Issued in FL
Practice address
380 Celebration PL FL 2
Celebration, FL 34747-4606
Phone
(407) 303-4760
Fax
(407) 303-4546
NPI assigned
Jul 19, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9110380 FL Primary
Physician Assistant 363A00000X 1818 WV

Addresses

Primary practice location

380 Celebration PL FL 2
Celebration, FL 34747-4606

Mailing address

380 Celebration PL FL 2
Celebration, FL 34747-4606
Phone (407) 303-4760

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
I20191106001890 FL Practitioner - Physician Assistant 2466784749 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

2501 N Orange Ave
Orlando, FL 32804-4641

2501 N Orange Ave
Suite 586
Orlando, FL 32804-4603
Phone (407) 303-6920

2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700

380 Celebration PL
FL 2
Celebration, FL 34747-4606
Phone (321) 939-3553

400 Celebration PL
Celebration, FL 34747-4970

601 E Rollins St
Orlando, FL 32803-1248
Phone (407) 303-2570

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1818WVMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc Physician Assistant CurrentSince Sep 30, 2019 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Sep 30, 2019 Accepting new patients

Locations

380 Celebration Pl
Fl 2
Kissimmee, FL 34747
Phone (407) 303-4190

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: lmckiernan73961@adventhealth.direct-ci.com

Organizations & group practices 2

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 2

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": "1468886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569196800000",
    "number": "1255784872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 CELEBRATION PL FL 2",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "347474606",
            "telephone_number": "407-303-4760",
            "fax_number": "407-303-4546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 CELEBRATION PL FL 2",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "347474606",
            "telephone_number": "407-303-4760",
            "fax_number": "407-303-4546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKIERNAN",
        "first_name": "LAUREN",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-19",
        "last_updated": "2019-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9110380",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "1818",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Celebration, FL

Sources for this page

Verify at the official NPI Registry.