Individual provider Active NPI

Anousone Karen Khamphoumy, APRN

  • Family Nurse Practitioner
  • Clearwater, FL
National Provider Identifier
1467348656
Registry record updated Jun 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11039928 Issued in FL
Practice address
501 S Lincoln Ave Ste 26
Clearwater, FL 33756-5964
Phone
(727) 498-0808
Fax
(727) 477-8303
NPI assigned
Jun 16, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2026

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 11039928 FL Primary

Addresses

Primary practice location

501 S Lincoln Ave Ste 26
Clearwater, FL 33756-5964

Mailing address

501 S Lincoln Ave Ste 26
Clearwater, FL 33756-5964
Phone (727) 498-0808

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
I20250902001688 FL Practitioner - Nurse Practitioner 2860993771 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tampa Bay Neurocognitive Institute PLLCGroup PAC ID 2769910397, 2 clinicians

Practice addresses (Care Compare)

501 S Lincoln Ave
Suite 26
Clearwater, FL 33756-5964
Phone (727) 498-0808

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11039928FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa Bay Neurocognitive Institute PLLC CurrentSince Aug 4, 2025 Accepting new patients

Locations

501 S Lincoln Ave
Ste 26
Clearwater, FL 33756
Phone (727) 442-2193

1433 Gulf To Bay Blvd
Ste F
Clearwater, FL 33755
Phone (727) 498-0808

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JJIEDD

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1750032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781827200000",
    "number": "1467348656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S LINCOLN AVE STE 26",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337565964",
            "telephone_number": "727-498-0808",
            "fax_number": "727-477-8303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S LINCOLN AVE STE 26",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337565964",
            "telephone_number": "727-498-0808",
            "fax_number": "727-477-8303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAMPHOUMY",
        "first_name": "ANOUSONE",
        "middle_name": "KAREN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-16",
        "last_updated": "2026-06-19",
        "certification_date": "2026-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11039928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.