Individual provider Active NPI

Kimberly Kay Nelson, APRN

  • Family Nurse Practitioner
  • Winter Park, FL
National Provider Identifier
1689114050
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN1803702 Issued in FL
Practice address
100 N Edinburgh Dr Ste 102
Winter Park, FL 32792-4125
Phone
(407) 845-8366
Fax
(407) 845-8367
NPI assigned
Mar 3, 2017
Last updated
Jun 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP1803702 FL
Family Nurse Practitioner 363LF0000X APRN1803702 FL Primary

Addresses

Primary practice location

100 N Edinburgh Dr Ste 102
Winter Park, FL 32792-4125

Mailing address

100 N Edinburgh Dr Ste 102
Winter Park, FL 32792-4125
Phone (407) 845-8366

Other identifiers 1

IdentifierTypeStateIssuer
021438200MedicaidFL

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
I20170614002930 FL Practitioner - Nurse Practitioner 4385912336 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sage Infusion, LLCGroup PAC ID 1254660467, 44 clinicians

Practice addresses (Care Compare)

910 Old Camp Rd
Suite 196
The Villages, FL 32162-5605
Phone (352) 565-5553

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ARNP1803702FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sage Infusion, LLC CurrentSince Jan 29, 2025 Accepting new patients
Florida Hospital Medical Group Inc Nurse Practitioner CurrentSince May 19, 2025 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince May 19, 2025 Accepting new patients

Locations

8880 Gladiolus Dr
Ste C200
Fort Myers, FL 33908
Phone (239) 533-5962

8550 NE 138th Ln
Ste 502
Lady Lake, FL 32159
Phone (352) 810-3536

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

4728 N Habana Ave
Ste 101B
Tampa, FL 33614
Phone (813) 775-9997

910 Old Camp Rd
Ste 196
The Villages, FL 32162
Phone (352) 565-5553

100 N Edinburgh Dr
Ste 102
Winter Park, FL 32792
Phone (407) 303-4190

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: knelson129009@adventhealth.direct-ci.com

Organizations & group practices 3

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": "1488499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750636800000",
    "number": "1689114050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N EDINBURGH DR STE 102",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327924125",
            "telephone_number": "407-845-8366",
            "fax_number": "407-845-8367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N EDINBURGH DR STE 102",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327924125",
            "telephone_number": "407-845-8366",
            "fax_number": "407-845-8367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "KIMBERLY",
        "middle_name": "KAY",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-03",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP1803702",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN1803702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "021438200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

Verify at the official NPI Registry.