Katerina Fagan, ACNPC-AG

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

11031708 Issued in FL

Practice address

435 Brookmeade Dr
Crestview, FL 32539-7304

Phone

(850) 605-0550

Fax

(850) 605-0440

NPI assigned

Jun 29, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Group practices

Emerald Coast Urology, LLCGroup PAC ID 8224503859, 2 clinicians

North Okaloosa Clinic CorpGroup PAC ID 0244205565, 27 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• North Okaloosa Medical Center Hospital, Crestview, FL, CCN 100122
• HCA Florida Twin Cities Hospital Hospital, Niceville, FL, CCN 100054
• HCA Florida Fort Walton-Destin Hospital Hospital, Fort Walton Beach, FL, CCN 100223
• Baptist Hospital Hospital, Pensacola, FL, CCN 100093

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: katerina.fagan.1@1523.direct.athenahealth.com

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.

• North Okaloosa Clinic Corp

  • Internal Medicine Physician
  • Crestview, FL
  • NPI 1659329852

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Emerald Coast Urology, LLC

  • Urology Physician
  • Crestview, FL
  • NPI 1033063268
  Medicare reassignment Care Compare group NPD (past)
• North Okaloosa Clinic Corp

  • Durable Medical Equipment & Medical Supplies
  • Crestview, FL
  • NPI 1477738896
  NPD
• West Florida Internal Medicine LLC

  • Internal Medicine Physician
  • Pensacola, FL
  • NPI 1679555833

  Multi-Specialty

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baptist Health Care, Inc

  • General Acute Care Hospital
  • Pensacola, FL
  • NPI 1700979465
  Care Compare affiliation
• Crestview Hospital Company, LLC

  dba North Okaloosa Medical Center

  • General Acute Care Hospital
  • Crestview, FL
  • NPI 1104897859
  Care Compare affiliation
• Fort Walton Beach Medical Center, Inc.

  dba HCA Florida Fort Walton-Destin Hospital

  • General Acute Care Hospital
  • Fort Walton Beach, FL
  • NPI 1639128820
  Care Compare affiliation
• Okaloosa Hospital Inc

  dba HCA Florida Twin Cities Hospital

  • General Acute Care Hospital
  • Niceville, FL
  • NPI 1891732988
  Care Compare affiliation

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

{
    "created_epoch": "1624924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779148800000",
    "number": "1356911671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1027",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325881027",
            "telephone_number": "850-605-0550",
            "fax_number": "850-605-0440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 BROOKMEADE DR",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325397304",
            "telephone_number": "850-605-0550",
            "fax_number": "850-605-0440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "320 Racetrack Rd NW Ste 100C",
            "address_purpose": "LOCATION",
            "city": "Fort Walton Beach",
            "state": "FL",
            "postal_code": "325471796",
            "country_code": "US",
            "telephone_number": "850-863-0883",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAGAN",
        "first_name": "KATERINA",
        "credential": "ACNPC-AG",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-29",
        "last_updated": "2026-05-19",
        "certification_date": "2026-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": "FL",
            "license": "11031708",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "APRN11031708",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1046195",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Homer D Estep, C.R.N.A.
• Chelsea Rayna Evans, O.D.
• William Lewis Everett, RPH
• Exit 56 Therapy Group LLC
• Eye Site of Crestivew PA
• Tricia Hope Fagan, LMHC
• John Myron Faircloth, NP
• Family Vision of Crestview LLC
• Hannah Felhofer, PA
• Anna Feliciano, PMHNP-BC

• Urology Physician in Crestview, FL
• Providers in Crestview, FL by specialty
• Urology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.