NPIMap

Individual provider Active NPI

Kristin L Hostetler, ARNP

  • Adult Health Nurse Practitioner
  • Fernandina Beach, FL
National Provider Identifier
1609156470
Registry record updated Jun 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APRN9356331 Issued in FL
Practice address
1132 S 14TH St
Fernandina Beach, FL 32034-2920
Phone
(904) 432-3061
Fax
(904) 432-3062
NPI assigned
Aug 24, 2011
Last updated
Jun 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X APRN9356331 FL Primary

Addresses

Primary practice location

1132 S 14TH St
Fernandina Beach, FL 32034-2920

Mailing address

2675 Winkler Ave FL 2
Fort Myers, FL 33901-9342
Phone (877) 856-3774

Other identifiers 1

IdentifierTypeStateIssuer
421334300MedicaidMD

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
I20170921000715 FL Practitioner - Nurse Practitioner 8123276508 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians

Practice addresses (Care Compare)

1132 S 14TH St
Fernandina Beach, FL 32034-2920
Phone (904) 277-4690

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN9356331FLMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Physician Specialists LLC CurrentSince Jun 18, 2017 Accepting new patients
Millennium Physician Group LLC CurrentSince Mar 27, 2023 Accepting new patients
Florida Physician Specialists LLC Current Accepting new patients
Baptist Cardiology, Inc. Nurse Practitioner CurrentSince Jan 8, 2018 Accepting new patients
Millennium Physician Group LLC CurrentSince Mar 27, 2023 Accepting new patients

Locations

14540 Cortez Blvd
Ste 102
Brooksville, FL 34613
Phone (352) 596-7255

1132 S 14th St
Fernandina Beach, FL 32034
Phone (904) 277-4690

1250 S 18th St
Ste 202
Fernandina Beach, FL 32034
Phone (904) 202-2000

1348 S 18th St
Ste 200
Fernandina Beach, FL 32034
Phone (904) 202-6683

2675 Winkler Ave
Fl 2
Fort Myers, FL 33901
Phone (855) 979-5700

6269 Beach Blvd
Ste 2
Jacksonville, FL 32216
Phone (904) 727-7955

710 Lomax St
Jacksonville, FL 32204
Phone (904) 306-6781

836 Prudential Dr
Ste 1700
Jacksonville, FL 32207
Phone (904) 398-0125

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

Interoperability endpoints

  • Direct secure messaging: khostetler20988@baptisthealthsystemjacksonville.direct-ci.com
  • Direct secure messaging: kristin.hostetler.1@4290.direct.athenahealth.com

Organizations & group practices 5

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 3

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": "1314144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686268800000",
    "number": "1609156470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "877-856-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1132 S 14TH ST",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320342920",
            "telephone_number": "904-432-3061",
            "fax_number": "904-432-3062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOSTETLER",
        "first_name": "KRISTIN",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-24",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN9356331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "421334300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fernandina Beach, FL

Sources for this page

Verify at the official NPI Registry.