Individual provider Active NPI

Kathryn Nolan, NP

  • Family Nurse Practitioner
  • Fort Walton Beach, FL
National Provider Identifier
1477431815
Registry record updated Aug 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11041060 Issued in FL
Practice address
1046 Mar Walt Dr # 200
Fort Walton Beach, FL 32547-6645
Phone
(850) 243-2229
NPI assigned
Aug 25, 2025
Last updated
Aug 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2025

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 11041060 FL Primary

Addresses

Primary practice location

1046 Mar Walt Dr # 200
Fort Walton Beach, FL 32547-6645

Mailing address

1046 Mar Walt Dr # 200
Fort Walton Beach, FL 32547-6645

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
I20260313002680 FL Practitioner - Nurse Practitioner 4082197306 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
Diana Health FL, PAGroup PAC ID 5092253245, 33 clinicians

Practice addresses (Care Compare)

1046 Mar Walt Dr
Suite 200
Fort Walton Beach, FL 32547-6645
Phone (850) 243-2229

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11041060FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Diana Health FL P.a. Family CurrentSince Mar 6, 2026 Accepting new patients

Locations

1046 Mar Walt Dr
Ste 200
Fort Walton Beach, FL 32547
Phone (850) 243-2229

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23211/brand/1/csg/21/fhir/r4
  • Direct secure messaging: katy.nolan.1@23211.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1756080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756080000000",
    "number": "1477431815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1046 MAR WALT DR # 200",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1046 MAR WALT DR # 200",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476645",
            "telephone_number": "850-243-2229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLAN",
        "first_name": "KATHRYN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-25",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11041060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

Verify at the official NPI Registry.