Individual provider Active NPI

Kayla Ann Gaughan, ARNP

  • Family Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1497285639
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9351273 Issued in FL
Practice address
8351 Westport Rd
Jacksonville, FL 32244-5901
Phone
(904) 317-8811
Fax
(904) 317-4949
NPI assigned
Jun 19, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 ARNP9351273 FL Primary

Addresses

Primary practice location

8351 Westport Rd
Jacksonville, FL 32244-5901

Mailing address

8351 Westport Rd
Jacksonville, FL 32244-5901
Phone (904) 317-8811

Other practice location 1

417 E Call St
Starke, FL 32091-3401
Phone (904) 368-0368

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
I20231219002384 FL Practitioner - Nurse Practitioner 7810347770 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9351273FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincents Ambulatory Care Inc CurrentSince Jan 1, 2024 Accepting new patients
St Vincents Ambulatory Care Inc CurrentSince Jan 1, 2024 Accepting new patients
Pediatric Associates at Argyle PA PastSince Aug 27, 2023 Accepting new patients
Pediatric Associates at Argyle PA Past Accepting new patients

Locations

2853 Henley Rd
Ste 104
Green Cove Springs, FL 32043
Phone (904) 602-4330

Interoperability endpoints

  • Direct secure messaging: kayla.gaughan.1@8967.direct.athenahealth.com

Organizations & group practices 4

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": "1497830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1497285639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8351 WESTPORT RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322445901",
            "telephone_number": "904-317-8811",
            "fax_number": "904-317-4949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8351 WESTPORT RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322445901",
            "telephone_number": "904-317-8811",
            "fax_number": "904-317-4949"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "417 E Call St",
            "address_purpose": "LOCATION",
            "city": "Starke",
            "state": "FL",
            "postal_code": "320913401",
            "country_code": "US",
            "telephone_number": "904-368-0368",
            "fax_number": "904-368-0378",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAUGHAN",
        "first_name": "KAYLA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-19",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9351273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.