NPIMap

Individual provider Active NPI

Kymberly D. Rittman, DO

  • Family Medicine Physician
  • Lynn Haven, FL
National Provider Identifier
1740370097
Registry record updated Feb 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0S10197 Issued in FL
Practice address
621 Florida Ave
Lynn Haven, FL 32444-1737
Phone
(850) 265-3606
Fax
(850) 271-0400
NPI assigned
Oct 14, 2006
Last updated
Feb 5, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2014

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 0S10197 FL Primary

Addresses

Primary practice location

621 Florida Ave
Lynn Haven, FL 32444-1737

Mailing address

621 Florida Ave
Lynn Haven, FL 32444-1737
Phone (850) 265-3606

Other identifiers 1

IdentifierTypeStateIssuer
1454COtherFLBCBS

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
I20080927000017 FL Practitioner - Family Practice 1254408651 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Health First Privia Medical GroupGroup PAC ID 3173965993, 247 clinicians
The Family Clinic LLCGroup PAC ID 2769558758, 2 clinicians

Practice addresses (Care Compare)

140 6TH Ave
Indialantic, FL 32903-3204
Phone (321) 312-3501

621 Florida Ave
Lynn Haven, FL 32444-1737
Phone (850) 265-3606

989 Sebastian Blvd
Unit 3
Sebastian, FL 32958-4879
Phone (727) 617-1777

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
0S10197FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Family Clinic LLC Family Medicine CurrentSince Sep 1, 2007 Accepting new patients
Privia Medical Group Florida, LLC CurrentSince Oct 2, 2025 Accepting new patients

Locations

140 6th Ave
Indialantic, FL 32903
Phone (321) 312-3501

621 Florida Ave
Lynn Haven, FL 32444
Phone (850) 265-3606

989 Sebastian Blvd
Unit 3
Sebastian, FL 32958
Phone (727) 617-1777

Organizations & group practices 2

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 7

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": "1160784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391558400000",
    "number": "1740370097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 FLORIDA AVE",
            "city": "LYNN HAVEN",
            "state": "FL",
            "postal_code": "324441737",
            "telephone_number": "850-265-3606",
            "fax_number": "850-271-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 FLORIDA AVE",
            "city": "LYNN HAVEN",
            "state": "FL",
            "postal_code": "324441737",
            "telephone_number": "850-265-3606",
            "fax_number": "850-271-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RITTMAN",
        "first_name": "KYMBERLY",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-14",
        "last_updated": "2014-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "0S10197",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1454C",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynn Haven, FL

Sources for this page

Verify at the official NPI Registry.