Kristy Laura Vandergriff, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

9419429 Issued in FL

Practice address

542325 US Highway 1
Callahan, FL 32011-6496

Phone

(904) 879-4233

NPI assigned

Jul 25, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kopa LLCGroup PAC ID 5193774461, 40 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Kopa LLC

  • Multi-Specialty Clinic/Center
  • Orlando, FL
  • NPI 1417021114
  Medicare reassignment Care Compare group NPD
• Dover Shores Family Practice

  • Family Medicine Physician
  • Orlando, FL
  • NPI 1417683707
  Medicare reassignment NPD
• Old City Health

  • Physical Medicine & Rehabilitation Physician
  • St Augustine, FL
  • NPI 1245008119
  NPD
• Primary Care Specialists of Orlando LLC

  • Family Medicine Physician
  • Orlando, FL
  • NPI 1740559939
  NPD
• Traditions Family Medicine, LLC

  • Family Medicine Physician
  • Orlando, FL
  • NPI 1548924236
  NPD

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

{
    "created_epoch": "1500940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1699298372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "542325 US HIGHWAY 1",
            "city": "CALLAHAN",
            "state": "FL",
            "postal_code": "320116496",
            "telephone_number": "904-879-4233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "542325 US HIGHWAY 1",
            "city": "CALLAHAN",
            "state": "FL",
            "postal_code": "320116496",
            "telephone_number": "904-879-4233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERGRIFF",
        "first_name": "KRISTY",
        "middle_name": "LAURA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-25",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NE",
            "license": "112224",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9419429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Robert Terrell IV, PHARM. D.
• Theramed Medical Associates LLC
• William David Titus, D.M.D.
• Trantek LLC
• Valuvision of Nassau County, Inc.
• Matthew Vangorder
• Avonlea A Veilleux, LCSW
• Amy Michelle Venturello, APRN
• Walgreen Co
• Margo Walton

• Family Nurse Practitioner in Callahan, FL
• Providers in Callahan, 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 Oct 27, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.