NPIMap

Individual provider Active NPI

Kelli M. Tyson, ARNP

  • Nurse Practitioner
  • St Augustine, FL
National Provider Identifier
1801304357
Registry record updated Dec 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP9229212 Issued in FL
Practice address
1100 Plantation Island Dr S Ste 220
St Augustine, FL 32080-5174
Phone
(904) 223-3321
Fax
(904) 223-2169
NPI assigned
Jan 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2024

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 ARNP9229212 FL Primary

Addresses

Primary practice location

1100 Plantation Island Dr S Ste 220
St Augustine, FL 32080-5174

Mailing address

5191 First Coast Tech Pkwy FL 3
Jacksonville, FL 32224-0609
Phone (904) 223-3321

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190925000073 FL Practitioner - Nurse Practitioner 2860722451 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
H2 Rehabilitation Services of Florida LLCGroup PAC ID 3971411851, shared by 10 NPIs, 257 clinicians

Practice addresses (Care Compare)

4900 SE Willoughby Blvd
Suite H2
Stuart, FL 34997-4009
Phone (800) 699-9395

5501 Muskogean St
Saint Augustine, FL 32092-0330
Phone (904) 465-1955

Hospital & facility affiliations

  • Bravery Home Healthcare Home health agency, St Augustine, FL, CCN 687344
  • Concierge Home Care Home health agency, St. Augustine, FL, CCN 687130
  • Trilogy Home Healthcare Home health agency, Jacksonville, FL, CCN 107689
  • Community Hospice of Northeast Florida Inc Hospice, Jacksonville, FL, CCN 101500
  • Vitas Healthcare Corporation of Florida Hospice, Melbourne, FL, CCN 101545

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9229212FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Hive PLLC Nurse Practitioner CurrentSince Oct 1, 2025 Accepting new patients
Mobile Visiting Practitioners, LLC CurrentSince Jul 30, 2019 Accepting new patients
Sound Physicians of Florida IV, LLC CurrentSince Mar 1, 2021 Accepting new patients
Karefirst Florida PA Nurse Practitioner CurrentSince Dec 30, 2024 Accepting new patients
Behavioral Health Services of Florida LLC CurrentSince Sep 15, 2021 Accepting new patients
Cogent Healthcare of Jacksonville, LLC CurrentSince Mar 1, 2021 Accepting new patients
Sound Physicians of Florida IV, LLC Nurse Practitioner CurrentSince Mar 1, 2021 Accepting new patients
Cogent Healthcare of Jacksonville, LLC Nurse Practitioner CurrentSince Mar 1, 2021 Accepting new patients

Locations

140 S Beach St
Ste 202
Daytona Beach, FL 32114
Phone (888) 506-8836

51 W Sample Rd
Deerfield Beach, FL 33064
Phone (954) 942-0941

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

1735 N Treasure Dr
North Bay Village, FL 33141
Phone (305) 665-2383

830 29th St
Orlando, FL 32805
Phone (407) 843-3230

400 Health Park Blvd
Ste 300
St Augustine, FL 32086
Phone (904) 819-4082

3100 E Fletcher Ave
#C
Tampa, FL 33613

Interoperability endpoints

  • Direct secure messaging: kelli.tyson@199.emedpractice.direct-ci.com
  • Direct secure messaging: kellityson@bgci.allscriptsdirect.net

Organizations & group practices 8

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 8

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": "1516233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1801304357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5191 FIRST COAST TECH PKWY FL 3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322240609",
            "telephone_number": "904-223-3321",
            "fax_number": "904-223-2169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 PLANTATION ISLAND DR S STE 220",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320805174",
            "telephone_number": "904-223-3321",
            "fax_number": "904-223-2169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYSON",
        "first_name": "KELLI",
        "middle_name": "M.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-18",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9229212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.