Individual provider Active NPI

Kelley Dawn Angelidis, FNP

  • Adult Health Nurse Practitioner
  • Winter Garden, FL
National Provider Identifier
1376325472
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APRN11028682 Issued in FL
Practice address
436 N Dillard St
Winter Garden, FL 34787-2817
Phone
(407) 877-8080
Fax
(407) 877-0907
NPI assigned
Oct 16, 2023
Last updated
Apr 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X APRN11028682 FL Primary
Family Nurse Practitioner 363LF0000X APRN11028682 FL

Addresses

Primary practice location

436 N Dillard St
Winter Garden, FL 34787-2817

Mailing address

436 N Dillard St
Winter Garden, FL 34787-2817
Phone (407) 877-8080

Other practice location 1

7599 W Sand Lake Rd
Orlando, FL 32819-5109
Phone (407) 352-1177

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
I20240214003194 FL Practitioner - Nurse Practitioner 3173967486 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Orlando Physicians Network IncGroup PAC ID 7719026251, 231 clinicians

Practice addresses (Care Compare)

436 N Dillard St
Winter Garden, FL 34787-2817
Phone (407) 877-8080

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic LLC Family CurrentSince Jan 11, 2024 Accepting new patients
Cappleman Edwards and Castello MD PA CurrentSince Apr 27, 2025 Accepting new patients
Orlando Physicians Network Inc Family Medicine CurrentSince May 1, 2025 Accepting new patients

Locations

121 W Macclenny Ave
Macclenny, FL 32063
Phone (904) 259-6380

12401 Miramar Pkwy
Miramar, FL 33027
Phone (954) 538-8473

21 Columbia St
Orlando, FL 32806
Phone (321) 841-5560

8765 S Dixie Hwy
Pinecrest, FL 33156
Phone (305) 740-6840

7599 W Sand Lake Rd
Sand Lake, FL 32819
Phone (407) 352-1177

436 N Dillard St
Winter Garden, FL 34787
Phone (407) 877-8080

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.

Hospital & facility affiliations 6

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": "1697414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1376325472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 N DILLARD ST",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347872817",
            "telephone_number": "407-877-8080",
            "fax_number": "407-877-0907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "436 N DILLARD ST",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347872817",
            "telephone_number": "407-877-8080",
            "fax_number": "407-877-0907"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7599 W Sand Lake Rd",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328195109",
            "country_code": "US",
            "telephone_number": "407-352-1177",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANGELIDIS",
        "first_name": "KELLEY",
        "middle_name": "DAWN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-16",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN11028682",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11028682",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Garden, FL

Sources for this page

Verify at the official NPI Registry.