Individual provider Active NPI

Kerry Dupuis, FNP-C

  • Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1528216934
Registry record updated Apr 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP3211912 Issued in FL
Practice address
1507 S Hiawassee Rd
Ste 105
Orlando, FL 32835-5706
Phone
(407) 445-9224
Fax
(407) 445-6236
NPI assigned
Aug 28, 2008
Last updated
Apr 28, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP3211912 FL Primary
Family Nurse Practitioner 363LF0000X ARNP3211912 FL

Addresses

Primary practice location

1507 S Hiawassee Rd
Ste 105
Orlando, FL 32835-5706

Mailing address

1507 S Hiawassee Rd
Ste 105
Orlando, FL 32835-5706
Phone (407) 445-9224

Other identifiers 3

IdentifierTypeStateIssuer
1730127655OtherFLMD NPI
ARNP3211912OtherFLFLORIDA LICENSE
1104864826OtherFLGROUP NPI

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
I20090312000243 FL Practitioner - Nurse Practitioner 7911063219 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Gastroenterology, P.a. CurrentSince Aug 16, 2019 Accepting new patients

Locations

255 Citrus Tower Blvd
Ste 207
Clermont, FL 34711
Phone (352) 742-4447

1507 S Hiawassee Rd
Ste 105
Orlando, FL 32835
Phone (407) 445-9224

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": "1219881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588032000000",
    "number": "1528216934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 S HIAWASSEE RD",
            "address_2": "STE 105",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328355706",
            "telephone_number": "407-445-9224",
            "fax_number": "407-445-6236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 S HIAWASSEE RD",
            "address_2": "STE 105",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328355706",
            "telephone_number": "407-445-9224",
            "fax_number": "407-445-6236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUPUIS",
        "first_name": "KERRY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-28",
        "last_updated": "2020-04-28",
        "certification_date": "2020-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP3211912",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP3211912",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD NPI",
            "identifier": "1730127655",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA LICENSE",
            "identifier": "ARNP3211912",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1104864826",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.