Active NPI
Kelly Renick, APRN
- Family Nurse Practitioner
- Sarasota, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- APRN9181416
- Practice address
- 1700 S Tamiami TRL
Sarasota, FL 34239-3509 - Phone
- (941) 917-4896
- Fax
- (941) 917-6884
- NPI assigned
- Jun 15, 2016
- Last updated
- Sep 23, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | APRN9181416 | FL | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
1700 S Tamiami TRL
Sarasota, FL 34239-3509
Mailing address
PO Box 863407
Orlando, FL 32886-3407
Phone (941) 917-2600
Other practice location 1
333 Tamiami Trl S
Suite 101
Venice, FL 34285-2402
Phone (941) 488-1906
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1700 S Tamiami TRL
Sarasota, FL 34239-3509
Phone (941) 917-7760
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SMH Physician Services Inc | Current | Accepting new patients |
Locations
1700 Tamiami Trl
Sarasota, FL 34239
Phone (941) 917-8507
1921 Waldemere St
Ste 307
Sarasota, FL 34239
Phone (941) 917-8565
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Organizations & group practices 1
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.
-
dba First Physicians Group
- Internal Medicine Physician
- Sarasota, FL
- NPI 1346295292
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Sarasota Memorial Hospital
- General Acute Care Hospital
- Sarasota, FL
- NPI 1245294826
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632355200000",
"number": "1427408962",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 863407",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328863407",
"telephone_number": "941-917-2600",
"fax_number": "941-917-7884"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 S TAMIAMI TRL",
"city": "SARASOTA",
"state": "FL",
"postal_code": "342393509",
"telephone_number": "941-917-4896",
"fax_number": "941-917-6884"
}
],
"practiceLocations": [
{
"address_1": "333 Tamiami Trl S",
"address_2": "Suite 101",
"address_purpose": "LOCATION",
"city": "Venice",
"state": "FL",
"postal_code": "342852402",
"country_code": "US",
"telephone_number": "941-488-1906",
"fax_number": "941-244-9326",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RENICK",
"first_name": "KELLY",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-15",
"last_updated": "2021-09-23",
"certification_date": "2021-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "FL",
"license": "APRN9181416",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Sarasota, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.