NPIMap

Organization Active NPI

KND Development 59 LLC

  • Hospitalist Physician
  • Melbourne, FL
National Provider Identifier
1366772337
Registry record updated Jun 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
Legal business name
KND DEVELOPMENT 59 LLC
Practice address
765 W Nasa Blvd
Melbourne, FL 32901-1815
Phone
(321) 733-5725
Fax
(502) 596-4150
NPI assigned
Jan 13, 2010
Last updated
Jun 11, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
KINDRED HEALTHCARE, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 11, 2020

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

Authorized official

Name
Linda L Fisher
Title
DVP Revenue Cycle
Phone
(502) 596-7358

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X Primary

Addresses

Primary practice location

765 W Nasa Blvd
Melbourne, FL 32901-1815

Mailing address

680 S 4TH St
Louisville, KY 40202-2407
Phone (502) 596-7300

Other identifiers 1

IdentifierTypeStateIssuer
DL118AOtherFLMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100908000056 FL Part B Supplier - Clinic/Group Practice 3678602802 Receives reassigned benefits from 175 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cantonment, FL; Coral Gables, FL; Fort Lauderdale, FL; Green Cove Springs, FL; Hollywood, FL; Melbourne, FL; Riviera Beach, FL; Saint Petersburg, FL…

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
KND Development 59 LLC78 organizations share this tax ID, including this one
Part of
Presence Covenant Medical Center

Organizations with this tax ID in the same state 7

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1263340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591833600000",
    "number": "1366772337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 S 4TH ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402022407",
            "telephone_number": "502-596-7300",
            "fax_number": "833-501-9731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 W NASA BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329011815",
            "telephone_number": "321-733-5725",
            "fax_number": "502-596-4150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KND DEVELOPMENT 59 LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KINDRED HEALTHCARE, INC",
        "enumeration_date": "2010-01-13",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A",
        "authorized_official_last_name": "FISHER",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DVP REVENUE CYCLE",
        "authorized_official_telephone_number": "502-596-7358"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "DL118A",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.