Individual provider Active NPI

Kaitlyn Zipoli Agudelo, C.N.M., A.R.N.P.

  • Advanced Practice Midwife
  • Orlando, FL
National Provider Identifier
1790026722
Registry record updated Jun 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
CNM1326 Issued in FL
Practice address
3000 Hunters Creek Blvd Ste 201
Orlando, FL 32837
Phone
(407) 857-2502
Fax
(407) 857-1855
NPI assigned
Mar 15, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 9312678 FL
Obstetrics & Gynecology Nurse Practitioner 363LX0001X RN 9312678 FL
Advanced Practice Midwife 367A00000X CNM1326 FL Primary

Addresses

Primary practice location

3000 Hunters Creek Blvd Ste 201
Orlando, FL 32837

Mailing address

3000 Hunters Creek Blvd
Orlando, FL 32837-6901
Phone (954) 854-4030

Other identifiers 1

IdentifierTypeStateIssuer
009211000MedicaidFL

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
I20151201000402 FL Practitioner - Nurse Practitioner 7113151655 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9312678FLMDNurse Practitioner
RN 9312678FLMDObstetrics & Gynecology Nurse Practitioner
CNM1326FLMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Women'S Care Florida LLC Nurse Practitioner CurrentSince Dec 1, 2015 Accepting new patients
Womencare PA Past Accepting new patients
Florida Woman Care, LLC Past Accepting new patients

Locations

10917 Dylan Loren Cir
Ste B
Orlando, FL 32825
Phone (407) 380-7998

2818 W Virginia Ave
Tampa, FL 33607
Phone (813) 872-8551

Interoperability endpoints

  • Direct secure messaging: kaitlyn.zipoli.1@2183.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1363305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561593600000",
    "number": "1790026722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 HUNTERS CREEK BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328376901",
            "telephone_number": "954-854-4030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 HUNTERS CREEK BLVD STE 201",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32837",
            "telephone_number": "407-857-2502",
            "fax_number": "407-857-1855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUDELO",
        "first_name": "KAITLYN",
        "middle_name": "ZIPOLI",
        "name_prefix": "Ms.",
        "credential": "C.N.M., A.R.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-15",
        "last_updated": "2019-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "9312678",
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "FL",
            "license": "RN 9312678",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "FL",
            "license": "CNM1326",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009211000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.