Kathleen Marie Korem Sperry, ARNP-BC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

ARNP1922572 Issued in FL

Practice address

731 N Clyde Morris Blvd
Daytona Beach, FL 32114-1603

Phone

(386) 257-1626

Fax

(866) 899-3686

NPI assigned

Oct 20, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kathleen.koremsperry@conviva.eclinicaldirectplus.com

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.

• Conviva Medical Center Management LLC

  • Internal Medicine Physician
  • Miami, FL
  • NPI 1649324278
  Medicare reassignment NPD
• Metcare of Florida, Inc

  • Internal Medicine Physician
  • Hialeah, FL
  • NPI 1902893225
  NPD (past)

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

{
    "created_epoch": "1255996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638576000000",
    "number": "1780910109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 BLUE LAGOON DR STE 400",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331262051",
            "telephone_number": "305-500-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 N CLYDE MORRIS BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321141603",
            "telephone_number": "386-257-1626",
            "fax_number": "866-899-3686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOREM SPERRY",
        "first_name": "KATHLEEN",
        "middle_name": "MARIE",
        "credential": "ARNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-20",
        "last_updated": "2021-12-04",
        "certification_date": "2021-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP1922572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kathleen.koremsperry@conviva.eclinicaldirectplus.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "731 N Clyde Morris Blvd",
            "city": "Daytona Beach",
            "state": "FL",
            "country_code": "US",
            "postal_code": "321141603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Madhavi Kondur Muppala, M.D.
• Sarah Stidham Koontz, MS, CCC-SLP
• Gina Alexandria Kopacki-Birt, LMHC
• Kopuri Orthodontist PA
• Brittany Dawn Korell, NP
• Diana Kotas
• Emilee Kott
• Dianne Kowing, O.D.
• Tomasz Kozlowski, M.D.
• Paul R. Krafft, M.D.

• Adult Health Nurse Practitioner in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Adult Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.