NPIMap

Individual provider Active NPI

Kristine M. Rednour, PA-C

  • Physician Assistant
  • Apollo Beach, FL
National Provider Identifier
1497767917
Registry record updated Mar 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9110106 Issued in FL
Practice address
282 Apollo Beach Blvd
Apollo Beach, FL 33572-2261
Phone
(813) 645-4068
Fax
(813) 645-0312
NPI assigned
Aug 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9110106 FL Primary

Addresses

Primary practice location

282 Apollo Beach Blvd
Apollo Beach, FL 33572-2261

Mailing address

282 Apollo Beach Blvd
Apollo Beach, FL 33572-2261
Phone (813) 645-4068

Other practice location 1

500 Vonderburg Dr Ste 311W
Brandon, FL 33511-5978
Phone (813) 654-2445

Other identifiers 1

IdentifierTypeStateIssuer
P00924300OtherINRAILROAD MEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170315001542 FL Practitioner - Physician Assistant 7113987207 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brandon Area Primary Care PAGroup PAC ID 1759288269, 12 clinicians

Practice addresses (Care Compare)

282 Apollo Beach Blvd
Apollo Beach, FL 33572-2261
Phone (813) 645-4068

500 Vonderburg Dr
Brandon, FL 33511-5978
Phone (813) 654-2445

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9110106FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Medical Specialists, LLC CurrentSince Jan 9, 2017 Accepting new patients
Florida Medical Specialists LLC CurrentSince Jan 9, 2017 Accepting new patients
Florida Medical Specialists LLC Past Accepting new patients
HPP Physicians LLC PastSince Jul 16, 2023 Accepting new patients

Locations

3844 Bee Ridge Rd
Fl 2
Sarasota, FL 34233
Phone (941) 202-5342

3830 Bee Ridge Rd
Ste 301
Sarasota, FL 34233
Phone (941) 923-1872

3830 Bee Ridge Rd
Ste 100
Sarasota, FL 34233
Phone (941) 921-0383

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553558400000",
    "number": "1497767917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "282 APOLLO BEACH BLVD",
            "city": "APOLLO BEACH",
            "state": "FL",
            "postal_code": "335722261",
            "telephone_number": "813-645-4068",
            "fax_number": "813-645-0312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "282 APOLLO BEACH BLVD",
            "city": "APOLLO BEACH",
            "state": "FL",
            "postal_code": "335722261",
            "telephone_number": "813-645-4068",
            "fax_number": "813-645-0312"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Vonderburg Dr Ste 311W",
            "address_purpose": "LOCATION",
            "city": "Brandon",
            "state": "FL",
            "postal_code": "335115978",
            "country_code": "US",
            "telephone_number": "813-654-2445",
            "fax_number": "813-654-9885",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REDNOUR",
        "first_name": "KRISTINE",
        "middle_name": "M.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-13",
        "last_updated": "2019-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9110106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "P00924300",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Apollo Beach, FL

Sources for this page

Verify at the official NPI Registry.