Individual provider Active NPI

Bethany Kaitlyn Carr, APRN

  • Acute Care Nurse Practitioner
  • Pensacola, FL
National Provider Identifier
1457066110
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
APRN11035285 Issued in FL
Practice address
5151 N 9TH Ave
Pensacola, FL 32504-8721
Phone
(850) 416-7000
NPI assigned
Jan 17, 2023
Last updated
Nov 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN9470896 FL
Acute Care Nurse Practitioner 363LA2100X APRN11035285 FL Primary

Addresses

Primary practice location

5151 N 9TH Ave
Pensacola, FL 32504-8721

Mailing address

9127 Tara Cir
Milton, FL 32583-4150
Phone (850) 816-9694

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
I20241202003386 FL Practitioner - Nurse Practitioner 4587199385 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1775 One Healing PL
Tallahassee, FL 32308-4600
Phone (850) 431-5360

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN9470896FLMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Services Group of Florida, LLC CurrentSince Nov 25, 2024 Accepting new patients
Tallahassee Memorial Healthcare Inc CurrentSince Nov 1, 2025 Accepting new patients
Tallahassee Memorial Healthcare Inc Current Accepting new patients
Careconnectmd Florida P.a. CurrentSince Feb 6, 2025 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients
Psgfl MSSP, LLC PastSince Jul 28, 2025 Accepting new patients

Locations

3090 Bristol St
Ste 200
Costa Mesa, CA 92626
Phone (714) 992-1182

15 Council Moore Rd
Crawfordville, FL 32327
Phone (850) 926-7105

8325 University Pkwy
Ste A
Pensacola, FL 32514
Phone (850) 324-9633

1401 Centerville Rd
Ste 400
Tallahassee, FL 32308
Phone (850) 431-3360

1775 One Healing Pl
Tallahassee, FL 32308
Phone (850) 431-4888

Organizations & group practices 6

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 1

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": "1673913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1457066110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9127 TARA CIR",
            "city": "MILTON",
            "state": "FL",
            "postal_code": "325834150",
            "telephone_number": "850-816-9694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5151 N 9TH AVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048721",
            "telephone_number": "850-416-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARR",
        "first_name": "BETHANY",
        "middle_name": "KAITLYN",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-17",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9470896",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "APRN11035285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.