Organization Active NPI

Rodaphne Advanced Healthcare Provider, LLC

  • Nurse Practitioner
  • Port Saint Lucie, FL
National Provider Identifier
1417870783
Registry record updated Aug 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
RODAPHNE ADVANCED HEALTHCARE PROVIDER, LLC
Practice address
1860 SW Fountainview Blvd Ste 100
Port Saint Lucie, FL 34986-4528
Phone
(772) 207-4900
Fax
(772) 404-7936
NPI assigned
Aug 3, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2026

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

Authorized official

Name
Dr. Kettelene Philogene McMorris, DNP, FNP, PMHNP
Title
Owner/Nurse Practitioner
Phone
(754) 366-1406

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

1860 SW Fountainview Blvd Ste 100
Port Saint Lucie, FL 34986-4528

Mailing address

1860 SW Fountainview Blvd Ste 100
Port Saint Lucie, FL 34986-4528
Phone (772) 207-4900

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1785715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785715200000",
    "number": "1417870783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 SW FOUNTAINVIEW BLVD STE 100",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349864528",
            "telephone_number": "772-207-4900",
            "fax_number": "772-404-7936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 SW FOUNTAINVIEW BLVD STE 100",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349864528",
            "telephone_number": "772-207-4900",
            "fax_number": "772-404-7936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RODAPHNE ADVANCED HEALTHCARE PROVIDER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-08-03",
        "last_updated": "2026-08-03",
        "certification_date": "2026-07-15",
        "status": "A",
        "authorized_official_last_name": "MCMORRIS",
        "authorized_official_first_name": "KETTELENE",
        "authorized_official_middle_name": "PHILOGENE",
        "authorized_official_title_or_position": "OWNER/NURSE PRACTITIONER",
        "authorized_official_telephone_number": "754-366-1406",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP, FNP, PMHNP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.