Individual provider Active NPI

Jennifer M Kelsey, ARNP

  • Nurse Practitioner
  • Winter Park, FL
National Provider Identifier
1740460930
Registry record updated Apr 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP9191787 Issued in FL
Practice address
4100 Metric Dr
Suite 200
Winter Park, FL 32792-6837
Phone
(407) 681-8720
Fax
(407) 681-8729
NPI assigned
Nov 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP9191787 FL Primary

Addresses

Primary practice location

4100 Metric Dr
Suite 200
Winter Park, FL 32792-6837

Mailing address

807 S Orlando Ave
Suite C
Winter Park, FL 32789-4870
Phone (407) 515-2212

Other identifiers 1

IdentifierTypeStateIssuer
308888000MedicaidFL

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
I20071217000210 FL Practitioner - Nurse Practitioner 8527158468 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nephrology Associates of Central Florida, P.a.Group PAC ID 2567359375, 34 clinicians

Practice addresses (Care Compare)

4100 Metric Dr
Suite 200
Winter Park, FL 32792-6832
Phone (407) 681-8720

Hospital & facility affiliations

  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9191787FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology Associates of Central Florida, P.a. CurrentSince Dec 1, 2007 Accepting new patients
Renal Access of Central Florida LLC Past Accepting new patients

Locations

2501 N Orange Ave
Ste 537N
Orlando, FL 32804
Phone (407) 894-4693

4100 Metric Dr
Ste 200
Winter Park, FL 32792
Phone (407) 681-8720

807 S Orlando Ave
Ste C
Winter Park, FL 32789
Phone (407) 894-4693

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1194307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209427200000",
    "number": "1740460930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 S ORLANDO AVE",
            "address_2": "SUITE C",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327894870",
            "telephone_number": "407-515-2212",
            "fax_number": "407-539-0469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 METRIC DR",
            "address_2": "SUITE 200",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327926837",
            "telephone_number": "407-681-8720",
            "fax_number": "407-681-8729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELSEY",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-06",
        "last_updated": "2008-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9191787",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "308888000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

Verify at the official NPI Registry.