Individual provider Active NPI

Carol McKinnon, ARNP, NP-C

  • Family Nurse Practitioner
  • Pembroke Pines, FL
National Provider Identifier
1336564731
Registry record updated May 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9278438 Issued in FL
Practice address
880 SW 145TH Ave Ste 202
Pembroke Pines, FL 33027-6171
Phone
(866) 849-0692
Fax
(888) 973-8821
NPI assigned
Feb 22, 2014
Last updated
May 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0033379 OH
Family Nurse Practitioner 363LF0000X 3-001637 AL
Family Nurse Practitioner 363LF0000X 36525 TN
Family Nurse Practitioner 363LF0000X 1191574 TX
Family Nurse Practitioner 363LF0000X ARNP9278438 FL Primary

Addresses

Primary practice location

880 SW 145TH Ave Ste 202
Pembroke Pines, FL 33027-6171

Mailing address

PO Box 211699
Eagan, MN 55121-3699
Phone (866) 849-0692

Other practice location 1

1324 Lakeland Hills Blvd
Lakeland, FL 33805-4543
Phone (863) 687-1321

Other names 1

  • Carol Kreeger Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, AL, TN3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20140715001712 FL Practitioner - Nurse Practitioner 0547485187 Reassigns benefits to 2 organizations
I20240608000101 AL Practitioner - Nurse Practitioner 0547485187 Reassigns benefits to 1 organization
I20240806000934 TN Practitioner - Nurse Practitioner 0547485187 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
36525TNMDPharmacist
3-001637ALMDFamily Nurse Practitioner
0033379OHMDFamily Nurse Practitioner
1191574TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Devoted Medical Group Professional Corporation CurrentSince Nov 14, 2022 Accepting new patients
Lakeland Regional Health Systems, Inc. CurrentSince May 17, 2014 Accepting new patients

Locations

1324 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 687-1132

3525 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 603-6565

880 SW 145th Ave
Ste 202
Pembroke Pines, FL 33027
Phone (813) 498-0260

221 Crescent St
Ste 202
Waltham, MA 02453
Phone (617) 958-1611

3200 West End Ave
Nashville, TN 37203
Phone (615) 946-3379

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, 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": "1393027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747008000000",
    "number": "1336564731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 211699",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551213699",
            "telephone_number": "866-849-0692",
            "fax_number": "888-973-8821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 SW 145TH AVE STE 202",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330276171",
            "telephone_number": "866-849-0692",
            "fax_number": "888-973-8821"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1324 Lakeland Hills Blvd",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338054543",
            "country_code": "US",
            "telephone_number": "863-687-1321",
            "fax_number": "863-603-6534",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKINNON",
        "first_name": "CAROL",
        "name_prefix": "Mr.",
        "credential": "ARNP, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-22",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "0033379",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "3-001637",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "36525",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1191574",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9278438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROL",
            "last_name": "KREEGER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.