Individual provider Active NPI

Kristen N Sweeney, PA-C

  • Physician Assistant
  • Fleming Island, FL
National Provider Identifier
1619297959
Registry record updated Jun 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9109458 Issued in FL
Practice address
2310 Village Square Pkwy Ste 204
Fleming Island, FL 32003-6409
Phone
(904) 224-5185
Fax
(905) 376-3202
NPI assigned
Jun 9, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9109458 FL Primary
Physician Assistant 363A00000X PA2014-0042 NM
Physician Assistant 363A00000X PA001212 ME

Addresses

Primary practice location

2310 Village Square Pkwy Ste 204
Fleming Island, FL 32003-6409

Mailing address

PO Box 746652
Atlanta, GA 30374-6652
Phone (047) 200-5999

Other practice location 1

1235 8th St
ECFH Las Vegas Clinic
Las Vegas, NM 87701-4219
Phone (505) 425-6788

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
I20160706000057 FL Practitioner - Physician Assistant 7214051986 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9109458FLMDPhysician Assistant
PA001212MEMDPhysician Assistant
PA2014-0042NMMDPhysician Assistant
2812SCMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
FL-I Medical Services LLC Physician Assistant CurrentSince May 2, 2016 Accepting new patients
FL-I Medical Services, LLC Physician Assistant CurrentSince May 2, 2016 Accepting new patients
Baptist Cardiology, Inc. Physician Assistant CurrentSince Jul 1, 2024 Accepting new patients
El Centro Family Health Past Accepting new patients
El Centro Family Health Past Accepting new patients

Locations

2310 Village Square Pkwy
Ste 204
Fleming Island, FL 32003
Phone (904) 224-5185

14534 Old Saint Augustine Rd
Ste 3420
Jacksonville, FL 32258
Phone (904) 493-8001

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

Interoperability endpoints

  • Direct secure messaging: kristen.sweeney.1@14940.direct.athenahealth.com
  • Direct secure messaging: ksweeney182509@baptisthealthsystemjacksonville.direct-ci.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1276041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780617600000",
    "number": "1619297959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746652",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746652",
            "telephone_number": "047-200-5999",
            "fax_number": "904-376-4036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 VILLAGE SQUARE PKWY STE 204",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320036409",
            "telephone_number": "904-224-5185",
            "fax_number": "905-376-3202"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1235 8th St",
            "address_2": "ECFH Las Vegas Clinic",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NM",
            "postal_code": "877014219",
            "country_code": "US",
            "telephone_number": "505-425-6788",
            "fax_number": "505-425-5408",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SWEENEY",
        "first_name": "KRISTEN",
        "middle_name": "N",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-09",
        "last_updated": "2026-06-05",
        "certification_date": "2026-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9109458",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2014-0042",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA001212",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fleming Island, FL

Sources for this page

Verify at the official NPI Registry.