Individual provider Active NPI

Kimberlee Ann Cavanaugh, ARNP-C

  • Family Nurse Practitioner
  • Merritt Island, FL
National Provider Identifier
1760637201
Registry record updated Dec 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP2686042 Issued in FL
Practice address
1500 E Merritt Island Cswy
Suite 300
Merritt Island, FL 32952-2612
Phone
(321) 452-3400
NPI assigned
Nov 25, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2009

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 ARNP2686042 FL Primary

Addresses

Primary practice location

1500 E Merritt Island Cswy
Suite 300
Merritt Island, FL 32952-2612

Mailing address

150 N Sykes Creek Pkwy
Suite 300
Merritt Island, FL 32953-3488
Phone (321) 449-4572

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
ARNP2686042FLMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1227571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261008000000",
    "number": "1760637201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 N SYKES CREEK PKWY",
            "address_2": "SUITE 300",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329533488",
            "telephone_number": "321-449-4572",
            "fax_number": "321-449-4164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E MERRITT ISLAND CSWY",
            "address_2": "SUITE 300",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329522612",
            "telephone_number": "321-452-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVANAUGH",
        "first_name": "KIMBERLEE",
        "middle_name": "ANN",
        "credential": "ARNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-25",
        "last_updated": "2009-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP2686042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merritt Island, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2009; 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.