Individual provider Active NPI

Kathryn L Szczepanik, ARNP

  • Family Nurse Practitioner
  • Fleming Island, FL
National Provider Identifier
1730344854
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP 9219129 Issued in FL
Practice address
4611 US Highway 17 Ste 1
Fleming Island, FL 32003-8248
Phone
(904) 264-4333
NPI assigned
Jul 29, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP 9219129 FL Primary

Addresses

Primary practice location

4611 US Highway 17 Ste 1
Fleming Island, FL 32003-8248

Mailing address

4611 US Highway 17 Ste 1
Fleming Island, FL 32003-8248
Phone (904) 264-4333

Other identifiers 1

IdentifierTypeStateIssuer
1730344854MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
ARNP 9219129FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group Florida, LLC Past Accepting new patients
Shelly L. Hall M.D., P.a. PastSince Jul 24, 2022 Accepting new patients
North Florida Pediatrics, PA Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kathryn.szczepanik.1@8042.direct.athenahealth.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": "1217289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1730344854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4611 US HIGHWAY 17 STE 1",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320038248",
            "telephone_number": "904-264-4333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4611 US HIGHWAY 17 STE 1",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320038248",
            "telephone_number": "904-264-4333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SZCZEPANIK",
        "first_name": "KATHRYN",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-29",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP 9219129",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1730344854",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fleming Island, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.