Individual provider Active NPI

Katie L Kerlin, ARNP

  • Family Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1366859373
Registry record updated Oct 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9277999 Issued in FL
Practice address
6444 Beach Blvd
Jacksonville, FL 32216-2891
Phone
(904) 805-9600
Fax
(904) 805-0084
NPI assigned
Jul 22, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP9277999 FL Primary

Addresses

Primary practice location

6444 Beach Blvd
Jacksonville, FL 32216-2891

Mailing address

6444 Beach Blvd
Jacksonville, FL 32216-2891
Phone (904) 805-9600

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
I20140930000301 FL Practitioner - Nurse Practitioner 7719107523 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Vincent'S Ambulatory Care IncGroup PAC ID 2860411188, 303 clinicians

Practice addresses (Care Compare)

1824 King St
Suite 300
Jacksonville, FL 32204-4736
Phone (904) 388-1820

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincents Ambulatory Care Inc CurrentSince Jul 17, 2017 Accepting new patients
St Vincents Ambulatory Care Inc CurrentSince Jul 17, 2017 Accepting new patients

Locations

2 Shircliff Way
Ste 400
Jacksonville, FL 32204
Phone (904) 308-4000

1824 King St
Ste 300
Jacksonville, FL 32204
Phone (904) 381-9393

4205 Belfort Rd
Ste 4015
Jacksonville, FL 32216
Phone (904) 296-5691

4205 Belfort Rd
Ste 2069
Jacksonville, FL 32216
Phone (904) 296-0278

2 Shircliff Way
Ste 300
Jacksonville, FL 32204
Phone (904) 308-7959

2300 Park Ave
Ste 101B
Orange Park, FL 32073
Phone (904) 249-4888

Interoperability endpoints

  • Direct secure messaging: katie.kerlin.1@8967.direct.athenahealth.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 3

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": "1405987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540944000000",
    "number": "1366859373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6444 BEACH BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322162891",
            "telephone_number": "904-805-9600",
            "fax_number": "904-805-0084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6444 BEACH BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322162891",
            "telephone_number": "904-805-9600",
            "fax_number": "904-805-0084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERLIN",
        "first_name": "KATIE",
        "middle_name": "L",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-22",
        "last_updated": "2018-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9277999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.