Individual provider Active NPI

Katelyn McGlaughlin

  • Gerontology Nurse Practitioner
  • Fort Myers, FL
National Provider Identifier
1366295552
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APRN11032129 Issued in FL
Practice address
8260 Gladiolus Dr
Fort Myers, FL 33908-4156
Phone
(239) 437-5755
Fax
(239) 437-5776
NPI assigned
Apr 8, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 11032129 FL
Gerontology Nurse Practitioner 363LG0600X APRN11032129 FL Primary

Addresses

Primary practice location

8260 Gladiolus Dr
Fort Myers, FL 33908-4156

Mailing address

PO Box 102222
Atlanta, GA 30368-2222
Phone (239) 274-8200

Other practice location 1

8981 Colonial Center Dr
Fort Myers, FL 33905-7816
Phone (239) 938-0800

Other practice location 2

1708 Cape Coral Pkwy W Ste 10
Cape Coral, FL 33914-6985
Phone (239) 541-4633

Other identifiers 1

IdentifierTypeStateIssuer
122446800MedicaidFL

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
I20240604003569 FL Practitioner - Nurse Practitioner 4183166283 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

8260 Gladiolus Dr
Fort Myers, FL 33908-4156
Phone (239) 437-5755

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11032129FLMDGerontology Nurse Practitioner
11032129FLMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Cancer Specialists & Research Institute, LLC CurrentSince May 28, 2024 Accepting new patients
Florida Cancer Specialists & Research Institute, LLC Past Accepting new patients

Locations

1708 Cape Coral Pkwy W
Ste 10
Cape Coral, FL 33914
Phone (239) 541-4633

1030 Commerce Creek Blvd
Cape Coral, FL 33909
Phone (239) 772-3544

8981 Colonial Center Dr
Fort Myers, FL 33905
Phone (239) 938-0800

8260 Gladiolus Dr
Fort Myers, FL 33908
Phone (239) 437-5755

3840 Broadway
Fort Myers, FL 33901
Phone (239) 275-6400

8260 Gladiolus Dr
Fl Cancer
Fort Myers, FL 33908
Phone (239) 437-5755

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

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, 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": "1712534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1366295552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 102222",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303682222",
            "telephone_number": "239-274-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8260 GLADIOLUS DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339084156",
            "telephone_number": "239-437-5755",
            "fax_number": "239-437-5776"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8981 Colonial Center Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339057816",
            "country_code": "US",
            "telephone_number": "239-938-0800",
            "fax_number": "866-420-0122",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1708 Cape Coral Pkwy W Ste 10",
            "address_purpose": "LOCATION",
            "city": "Cape Coral",
            "state": "FL",
            "postal_code": "339146985",
            "country_code": "US",
            "telephone_number": "239-541-4633",
            "fax_number": "866-504-2990",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCGLAUGHLIN",
        "first_name": "KATELYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-08",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "11032129",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "APRN11032129",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122446800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.