Individual provider Active NPI

Kristen Nicole Moore

  • Family Nurse Practitioner
  • Saint Cloud, FL
National Provider Identifier
1629703319
Registry record updated Oct 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11020848 Issued in FL
Practice address
3704 Fanciful CT
Saint Cloud, FL 34772-8239
Phone
(407) 744-2423
NPI assigned
Jul 18, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 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 11020848 FL Primary

Addresses

Primary practice location

3704 Fanciful CT
Saint Cloud, FL 34772-8239

Mailing address

3704 Fanciful CT
Saint Cloud, FL 34772-8239
Phone (407) 744-2423

Other practice location 1

1414 E Osceola Pkwy
Kissimmee, FL 34744-1611
Phone (407) 452-3700

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
I20220825001437 FL Practitioner - Nurse Practitioner 0446634497 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carespot of Orlando Hsi Urgent Care LLCGroup PAC ID 8921372558, 55 clinicians

Practice addresses (Care Compare)

2323 S Orange Ave a
Carespot Urgent Care
Orlando, FL 32806-3059
Phone (407) 418-9999

3840 State Rd
436 Suite 1000
Apopka, FL 32703-6041
Phone (615) 600-4074

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11020848FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Solantic of Jacksonville, LLC CurrentSince Mar 25, 2024 Accepting new patients
Hma/Solantic Joint Venture, LLC CurrentSince Mar 25, 2024 Accepting new patients
Carespot of Orlando Hsi Urgent Care LLC CurrentSince Mar 25, 2024 Accepting new patients
West Boynton Urgent Care, LLC CurrentSince Mar 25, 2024 Accepting new patients
Solantic/South Florida, LLC CurrentSince Mar 25, 2024 Accepting new patients

Locations

3840 State Road 436
Ste 1
Apopka, FL 32703
Phone (407) 478-3202

8756 Boynton Rd W
Ste 150
Boynton Beach, FL 33472
Phone (561) 740-2273

1615 E Highway 50
Ste 200
Clermont, FL 34711
Phone (352) 404-4463

2401 Monument Rd
Jacksonville, FL 32225
Phone (904) 642-0337

1414 E Osceola Pkwy
Kissimmee, FL 34744
Phone (407) 452-3700

18706 NW 67th Ave
Miami Gardens, FL 33015
Phone (786) 563-0280

9035 Pines Blvd
Pembroke Pines, FL 33024
Phone (954) 340-5881

1820 58th Ave
Ste 110
Vero Beach, FL 32966
Phone (772) 257-3200

463941 State Road 200
Yulee, FL 32097
Phone (904) 572-1959

Networks

  • Freedom Health HMO Network

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1658102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1629703319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3704 FANCIFUL CT",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347728239",
            "telephone_number": "407-744-2423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3704 FANCIFUL CT",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347728239",
            "telephone_number": "407-744-2423"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1414 E Osceola Pkwy",
            "address_purpose": "LOCATION",
            "city": "Kissimmee",
            "state": "FL",
            "postal_code": "347441611",
            "country_code": "US",
            "telephone_number": "407-452-3700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KRISTEN",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-18",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11020848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, FL

Sources for this page

Verify at the official NPI Registry.