NPIMap

Individual provider Active NPI

Kelly Kevitt, ARNP

  • Primary Care Nurse Practitioner
  • Leesburg, FL
National Provider Identifier
1740207497
Registry record updated Sep 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
APRN9178446 Issued in FL
Practice address
700 Doctors CT
Leesburg, FL 34748-7314
Phone
(352) 323-5665
Fax
(352) 265-1098
NPI assigned
Jul 17, 2006
Last updated
Sep 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9178446 FL
Primary Care Nurse Practitioner 363LP2300X APRN9178446 FL Primary

Addresses

Primary practice location

700 Doctors CT
Leesburg, FL 34748-7314

Mailing address

700 Doctors CT
Leesburg, FL 34748-7314
Phone (352) 323-5665

Other identifiers 2

IdentifierTypeStateIssuer
3080927-00MedicaidFL
2007009890OtherFLAMERICAN NURSES CREDENTIALING CENTER

Other names 1

  • Kelly Stacy-Haines Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070130000528 FL Practitioner - Nurse Practitioner 1355342577 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Villages Regional Hospital Physician Services LLCGroup PAC ID 0244688893, 198 clinicians

Practice addresses (Care Compare)

10435 SE 170TH PL
Summerfield, FL 34491-8998
Phone (352) 255-3615

705 Doctors CT
Leesburg, FL 34748-7315
Phone (352) 787-9838

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
9178446FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lake America Family Physicians LLC CurrentSince Apr 9, 2024 Accepting new patients
Villages Regional Hospital Physician Services LLC CurrentSince Jun 1, 2025 Accepting new patients
Bond Urgent Care LLC Past Accepting new patients

Locations

301 Frontage Rd
Unit G
Clermont, FL 34711
Phone (352) 432-3939

10435 SE 170th Pl
Summerfield, FL 34491
Phone (352) 245-7788

Interoperability endpoints

  • Direct secure messaging: kelly.stacyhaines.p1@direct.bondclinicpa.nextgenshare.com
  • Direct secure messaging: kkevitt789548@direct.shands.ufl.edu

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.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788825600000",
    "number": "1740207497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 DOCTORS CT",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347487314",
            "telephone_number": "352-323-5665",
            "fax_number": "352-265-1098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 DOCTORS CT",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347487314",
            "telephone_number": "352-323-5665",
            "fax_number": "352-265-1098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEVITT",
        "first_name": "KELLY",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9178446",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "APRN9178446",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3080927-00",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN NURSES CREDENTIALING CENTER",
            "identifier": "2007009890",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "STACY-HAINES",
            "credential": "ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Leesburg, FL

Sources for this page

Verify at the official NPI Registry.