Individual provider Active NPI

Emma Kingett

  • Family Nurse Practitioner
  • Melbourne, FL
National Provider Identifier
1619652625
Registry record updated Jun 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11026969 Issued in FL
Practice address
1900 S Harbor City Blvd
Ste 225
Melbourne, FL 32901
Phone
(321) 216-2288
NPI assigned
Jun 19, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 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 11026969 FL Primary

Addresses

Primary practice location

1900 S Harbor City Blvd
Ste 225
Melbourne, FL 32901

Mailing address

241 Canaveral Beach Blvd
Cape Canaveral, FL 32920-2657

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
I20230821003969 FL Practitioner - Nurse Practitioner 9436511565 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11026969FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Practitioners in Motion PLLC CurrentSince Jun 15, 2023 Accepting new patients

Locations

1785 Waverly Pl
Ste A
Melbourne, FL 32901
Phone (321) 216-2288

1900 S Harbor City Blvd
Ste 225
Melbourne, FL 32901
Phone (321) 216-2288

Interoperability endpoints

  • Direct secure messaging: emma.kingett.1@10787.direct.athenahealth.com

Organizations & group practices 2

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": "1687132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1619652625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241 CANAVERAL BEACH BLVD",
            "city": "CAPE CANAVERAL",
            "state": "FL",
            "postal_code": "329202657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 S HARBOR CITY BLVD",
            "address_2": "STE 225",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "32901",
            "telephone_number": "321-216-2288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINGETT",
        "first_name": "EMMA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-19",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11026969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.