Kaitlyn Connor Matheney, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

28406 Issued in TN

Practice address

5551 US Highway 98 W
Santa Rosa Beach, FL 32459-3566

Phone

(205) 565-1232

NPI assigned

Jun 16, 2021

Last updated

Feb 21, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Rural Primary Care South-Walton, Inc.

  • Internal Medicine Physician
  • Santa Rosa Beach, FL
  • NPI 1912545955
  NPD (past)

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

{
    "created_epoch": "1623801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676937600000",
    "number": "1689242463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 AUTUMN AVE",
            "city": "FREEPORT",
            "state": "FL",
            "postal_code": "324394250",
            "telephone_number": "270-508-0745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5551 US HIGHWAY 98 W",
            "city": "SANTA ROSA BEACH",
            "state": "FL",
            "postal_code": "324593566",
            "telephone_number": "205-565-1232"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "160 Autumn Ave",
            "address_purpose": "LOCATION",
            "city": "Freeport",
            "state": "FL",
            "postal_code": "324394250",
            "country_code": "US",
            "telephone_number": "615-367-2211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATHENEY",
        "first_name": "KAITLYN",
        "middle_name": "CONNOR",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-16",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "28406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "28406",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "EPIC",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2788 Murfreesboro Pike",
            "city": "Antioch",
            "state": "TN",
            "country_code": "US",
            "postal_code": "370132004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• John McDorman, PT, DPT
• Gary McFadyen, H.I.S.
• Jessica Nicole McKeever

• Family Nurse Practitioner in Santa Rosa Beach, FL
• Providers in Santa Rosa Beach, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.