Individual provider Active NPI

Kailla Raimer-Harris, FNP-C

  • Family Nurse Practitioner
  • Hudson, FL
National Provider Identifier
1609491885
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11007361 Issued in FL
Practice address
12582 US-19
Hudson, FL 34667
Phone
(727) 619-0547
NPI assigned
Jun 12, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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 11007361 FL Primary

Addresses

Primary practice location

12582 US-19
Hudson, FL 34667

Mailing address

220 Argyll Dr
Spring Hill, FL 34609-6542

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
I20201215002373 FL Practitioner - Nurse Practitioner 1557773595

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11007361FLMDFamily Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1591920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1609491885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 ARGYLL DR",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "346096542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12582 US-19",
            "city": "HUDSON",
            "state": "FL",
            "postal_code": "34667",
            "telephone_number": "727-619-0547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAIMER-HARRIS",
        "first_name": "KAILLA",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-12",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11007361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, FL

Sources for this page

Verify at the official NPI Registry.