Individual provider Active NPI

Kenna M Medley, ARNP

  • Family Nurse Practitioner
  • Naples, FL
National Provider Identifier
1811476302
Registry record updated Nov 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9318214 Issued in FL
Practice address
130 Tamiami TRL N Ste 220
Naples, FL 34102-6233
Phone
(239) 624-1700
Fax
(239) 434-8605
NPI assigned
Aug 7, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP9318214 FL Primary
Nurse Practitioner 363L00000X ARNP9318214 FL

Addresses

Primary practice location

130 Tamiami TRL N Ste 220
Naples, FL 34102-6233

Mailing address

130 Tamiami TRL N Ste 220
Naples, FL 34102-6233
Phone (239) 624-1700

Other practice location 1

350 7th St N
Naples, FL 34102-5754
Phone (239) 624-1890

Other identifiers 3

IdentifierTypeStateIssuer
100606900MedicaidFL
PL5ZROtherFLBCBS
JL934OtherFLMEDICARE

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
I20180918003658 FL Practitioner - Nurse Practitioner 8022369875 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nchmd IncGroup PAC ID 9436139565, 503 clinicians

Practice addresses (Care Compare)

130 Tamiami TRL N
Suite 220
Naples, FL 34102-6233
Phone (239) 434-5700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.25 of 100Reported as apm
Quality
87.73
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9318214FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nchmd, Inc CurrentSince Sep 1, 2018 Accepting new patients
Nchmd Inc CurrentSince Sep 1, 2018 Accepting new patients
Orthopedic Center of Florida, Inc CurrentSince Nov 1, 2022 Accepting new patients
Orthopedic Center of Florida, Inc CurrentSince Nov 1, 2022 Accepting new patients

Locations

12670 Creekside Ln
Ste 202
Fort Myers, FL 33919
Phone (239) 267-2263

680 2nd Ave N
Ste 304
Naples, FL 34102
Phone (239) 261-7711

130 Tamiami Trl N
Ste 220
Naples, FL 34102
Phone (239) 312-7800

350 7th St N
Naples, FL 34102
Phone (239) 436-5000

1285 Creekside Blvd E
Unit 102
Naples, FL 34109
Phone (239) 624-0310

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: kmedley23072@nchhealthcaresystem.direct-ci.com

Organizations & group practices 4

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 2

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": "1533600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541548800000",
    "number": "1811476302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 TAMIAMI TRL N STE 220",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341026233",
            "telephone_number": "239-624-1700",
            "fax_number": "239-434-8605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 TAMIAMI TRL N STE 220",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341026233",
            "telephone_number": "239-624-1700",
            "fax_number": "239-434-8605"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 7th St N",
            "address_purpose": "LOCATION",
            "city": "Naples",
            "state": "FL",
            "postal_code": "341025754",
            "country_code": "US",
            "telephone_number": "239-624-1890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDLEY",
        "first_name": "KENNA",
        "middle_name": "M",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-07",
        "last_updated": "2018-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9318214",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9318214",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100606900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "PL5ZR",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "JL934",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

Verify at the official NPI Registry.