Individual provider Active NPI

Kayla Ashante Clemons, APRN

  • Family Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1558847509
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9260493 Issued in FL
Practice address
4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone
(904) 953-2000
NPI assigned
Jul 12, 2018
Last updated
Jun 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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 APRN9260493 FL
Family Nurse Practitioner 363LF0000X ARNP9260493 FL Primary

Addresses

Primary practice location

4500 San Pablo Rd S
Jacksonville, FL 32224-1865

Mailing address

1921 Waldemere St Ste 705
Sarasota, FL 34239-2913
Phone (941) 366-5864

Other practice location 1

1700 S Tamiami Trl
Sarasota, FL 34239-3555
Phone (941) 917-9000

Other practice location 2

2600 Laurel Rd E
North Venice, FL 34275-3226
Phone (941) 917-9000

Other practice location 3

1921 Waldemere St
Sarasota, FL 34239-2943
Phone (941) 366-5864

Other identifiers 1

IdentifierTypeStateIssuer
100466100MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kclemons2455491@ehrdirect.mayoclinicmsg.org

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
I20181018000174 FL Practitioner - Nurse Practitioner 1052663119 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mayo Clinic JacksonvilleGroup PAC ID 5698689297, 1,595 clinicians

Practice addresses (Care Compare)

4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone (904) 953-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9260493FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Jacksonville CurrentSince Apr 7, 2025 Accepting new patients
SMH Physician Services Inc Nurse Practitioner CurrentSince Aug 1, 2024 Accepting new patients
Mayo Clinic Jacksonville Current Accepting new patients
Lung Associates of Sarasota LLC CurrentSince Oct 1, 2018 Accepting new patients
Mayo Clinic Jacksonville CurrentSince Apr 7, 2025 Accepting new patients
Sarasota County Public Hospital District Past Accepting new patients

Locations

4500 San Pablo Rd S
Jacksonville, FL 32224
Phone (904) 721-4815

200 Healthcare Way
Unit 102
North Venice, FL 34275
Phone (941) 366-5864

2600 Laurel Rd E
North Venice, FL 34275
Phone (941) 261-9000

1700 Tamiami Trl
Sarasota, FL 34239
Phone (941) 917-8507

1895 Floyd St
Sarasota, FL 34239
Phone (813) 366-5864

1921 Waldemere St
Sarasota, FL 34239
Phone (941) 914-2600

1921 Waldemere St
Ste 307
Sarasota, FL 34239
Phone (941) 917-8565

1921 Waldemere St
Ste 705
Sarasota, FL 34239
Phone (941) 366-5864

Interoperability endpoints

  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10086560
  • Direct secure messaging: kaylaclemons@las.allscriptsdirect.net
  • Direct secure messaging: kclemons2455491@ehrdirect.mayoclinicmsg.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1531353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1558847509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1921 WALDEMERE ST STE 705",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342392913",
            "telephone_number": "941-366-5864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 SAN PABLO RD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322241865",
            "telephone_number": "904-953-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 S Tamiami Trl",
            "address_purpose": "LOCATION",
            "city": "Sarasota",
            "state": "FL",
            "postal_code": "342393555",
            "country_code": "US",
            "telephone_number": "941-917-9000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2600 Laurel Rd E",
            "address_purpose": "LOCATION",
            "city": "North Venice",
            "state": "FL",
            "postal_code": "342753226",
            "country_code": "US",
            "telephone_number": "941-917-9000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1921 Waldemere St",
            "address_purpose": "LOCATION",
            "city": "Sarasota",
            "state": "FL",
            "postal_code": "342392943",
            "country_code": "US",
            "telephone_number": "941-366-5864",
            "fax_number": "941-365-4276",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLEMONS",
        "first_name": "KAYLA",
        "middle_name": "ASHANTE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-12",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN9260493",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9260493",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100466100",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kclemons2455491@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "4500 San Pablo Rd S",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322241865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.