Individual provider Active NPI

Kendle Lashoan Jones

  • Nurse Practitioner
  • Lynn Haven, FL
National Provider Identifier
1609761121
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11040229 Issued in FL
Practice address
4000 Arbor Trace Dr Unit C
Lynn Haven, FL 32444-6734
Phone
(334) 805-7918
Fax
(334) 805-7918
NPI assigned
Jun 12, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 9429487 FL
Nurse Practitioner 363L00000X 11040229 FL Primary

Addresses

Primary practice location

4000 Arbor Trace Dr Unit C
Lynn Haven, FL 32444-6734

Mailing address

4000 Arbor Trace Dr Unit C
Lynn Haven, FL 32444-6734
Phone (334) 805-7918

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
I20260116001603 FL Practitioner - Nurse Practitioner 3678050960 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mana Health Partners PAGroup PAC ID 3971952813, 102 clinicians

Practice addresses (Care Compare)

626 N Tyndall Pkwy
Callaway, FL 32404-6132
Phone (732) 719-5039

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9429487FLMDRegistered Nurse
11040229FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mana Health Partners PA CurrentSince Dec 10, 2025 Accepting new patients

Locations

626 N Tyndall Pkwy
Panama City, FL 32404
Phone (850) 625-5551

1507 S Tuttle Ave
Sarasota, FL 34239
Phone (941) 366-0336

338 Whitesville Rd
Ste 103
Jackson, NJ 08527

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1749686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751414400000",
    "number": "1609761121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 ARBOR TRACE DR UNIT C",
            "city": "LYNN HAVEN",
            "state": "FL",
            "postal_code": "324446734",
            "telephone_number": "334-805-7918",
            "fax_number": "334-805-7918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 ARBOR TRACE DR UNIT C",
            "city": "LYNN HAVEN",
            "state": "FL",
            "postal_code": "324446734",
            "telephone_number": "334-805-7918",
            "fax_number": "334-805-7918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "KENDLE",
        "middle_name": "LASHOAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-12",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9429487",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11040229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynn Haven, FL

Sources for this page

Verify at the official NPI Registry.