Active NPI
Kathryn Nolan, NP
- Family Nurse Practitioner
- Fort Walton Beach, FL
National Provider Identifier
1477431815
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 11041060
- 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, 2025
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 11041060 | FL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Diana Health FL P.a. | Family | Current | Accepting new patients |
Locations
1046 Mar Walt Dr
Ste 200
Fort Walton Beach, FL 32547
Phone (850) 243-2229
Interoperability endpoints
- https://api.platform.athenahealth.com/23211/brand/1/csg/21/fhir/r4
- 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2025; 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.