Individual provider Active NPI

Karelyn E Lotz

  • Contractor
  • Fernandina Beach, FL
National Provider Identifier
1780875948
Registry record updated Aug 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
Practice address
1620 Nectarine St
Fernandina Beach, FL 32034-4724
Phone
(904) 548-1860
Fax
(904) 277-7283
NPI assigned
Aug 5, 2007
Last updated
Aug 5, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X Primary

Addresses

Primary practice location

1620 Nectarine St
Fernandina Beach, FL 32034-4724

Mailing address

PO Box 517
Fernandina Beach, FL 32035-0517
Phone (904) 548-1800

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Department of Health Past Accepting new patients
Florida Department of Health PastSince Mar 9, 2014 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186272000000",
    "number": "1780875948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 517",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320350517",
            "telephone_number": "904-548-1800",
            "fax_number": "904-277-7286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 NECTARINE ST",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320344724",
            "telephone_number": "904-548-1860",
            "fax_number": "904-277-7283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOTZ",
        "first_name": "KARELYN",
        "middle_name": "E",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-05",
        "last_updated": "2007-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fernandina Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2007; 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.