Individual provider Active NPI

Katheryn Cabrera

  • Psychiatric/Mental Health Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1720428113
Registry record updated Jan 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN9191623 Issued in FL
Practice address
12780 Waterford Lakes Pkwy
Suite 120
Orlando, FL 32828-4500
Phone
(407) 384-1053
Fax
(407) 277-8168
NPI assigned
Jun 28, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9191623 FL
Nurse Practitioner 363L00000X ARNP9191623 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN9191623 FL Primary

Addresses

Primary practice location

12780 Waterford Lakes Pkwy
Suite 120
Orlando, FL 32828-4500

Mailing address

12780 Waterford Lakes Pkwy
Suite 120
Orlando, FL 32828-4500
Phone (407) 384-1053

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
I20131108001816 FL Practitioner - Nurse Practitioner 5991930455 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9191623FLMDFamily Nurse Practitioner
APRN9191623FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sma Healthcare, Inc CurrentSince Jul 6, 2021 Accepting new patients
Minuteclinic LLC Nurse Practitioner CurrentSince Nov 4, 2013 Accepting new patients
Sma Healthcare Inc CurrentSince Jul 6, 2021 Accepting new patients

Locations

301 Justice Ln
Bunnell, FL 32110
Phone (386) 236-1726

1220 Willis Ave
Daytona Beach, FL 32114
Phone (386) 236-3200

150 Magnolia Ave
Daytona Beach, FL 32114
Phone (386) 236-3215

121 W Macclenny Ave
Macclenny, FL 32063
Phone (904) 259-6380

5664 SW 60th Ave
Ocala, FL 34474
Phone (352) 291-5555

7599 W Sand Lake Rd
Sand Lake, FL 32819
Phone (407) 352-0943

Interoperability endpoints

  • Direct secure messaging: katheryn.cabrera.p1@direct.smahealthcare.nextgenshare.com

Organizations & group practices 4

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.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sma Healthcare Inc 39 clinicians

Practice addresses (Care Compare)

5664 SW 60TH Ave
Ocala, FL 34474-5677
Phone (352) 291-5555

NPI Registry JSON

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

{
    "created_epoch": "1372377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547683200000",
    "number": "1720428113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12780 WATERFORD LAKES PKWY",
            "address_2": "SUITE 120",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328284500",
            "telephone_number": "407-384-1053",
            "fax_number": "407-277-8168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12780 WATERFORD LAKES PKWY",
            "address_2": "SUITE 120",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328284500",
            "telephone_number": "407-384-1053",
            "fax_number": "407-277-8168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CABRERA",
        "first_name": "KATHERYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-28",
        "last_updated": "2019-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9191623",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9191623",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN9191623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.