Individual provider Active NPI

Katherine Ann Yelvington, APRN

  • Family Medicine Physician
  • Deland, FL
National Provider Identifier
1699501361
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
APRN11035151 Issued in FL
Practice address
630 W Plymouth Ave
Deland, FL 32720-3260
Phone
(386) 734-3654
NPI assigned
Sep 10, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X APRN11035151 FL Primary

Addresses

Primary practice location

630 W Plymouth Ave
Deland, FL 32720-3260

Mailing address

205 Sandyhook LN
Deland, FL 32724-1313
Phone (386) 785-4107

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
I20260324003029 FL Practitioner - Nurse Practitioner 5496239709 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

695 N Clyde Morris Blvd
Daytona Beach, FL 32114-2321

695 N Clyde Morris Blvd
Daytona Beach, FL 32114-2398

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN11035151FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lewis & Klancke Cardiology PA CurrentSince Feb 1, 2026 Accepting new patients

Locations

630 W Plymouth Ave
Deland, FL 32720
Phone (386) 734-3654

938 Saxon Blvd
Ste 101C
Orange City, FL 32763
Phone (386) 774-5485

Organizations & group practices 1

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": "1725926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1699501361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 SANDYHOOK LN",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327241313",
            "telephone_number": "386-785-4107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 W PLYMOUTH AVE",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327203260",
            "telephone_number": "386-734-3654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YELVINGTON",
        "first_name": "KATHERINE",
        "middle_name": "ANN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-10",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "APRN11035151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deland, FL

Sources for this page

Verify at the official NPI Registry.