Individual provider Active NPI

Kyla Faille, MD

  • Family Medicine Physician
  • Ormond Beach, FL
National Provider Identifier
1811480809
Registry record updated May 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME141908 Issued in FL
Practice address
461 S Nova Rd
Ormond Beach, FL 32174-6138
Phone
(386) 671-4337
Fax
(386) 481-6182
NPI assigned
Jun 13, 2018
Last updated
May 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X TRN27048 FL
Family Medicine Physician 207Q00000X ME141908 FL Primary

Addresses

Primary practice location

461 S Nova Rd
Ormond Beach, FL 32174-6138

Mailing address

461 S Nova Rd
Ormond Beach, FL 32174-6138
Phone (386) 671-4337

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200629001963 FL Practitioner - Family Practice 6709120652 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Georgia School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Health Care Plan IncGroup PAC ID 9436201233, 97 clinicians

Practice addresses (Care Compare)

461 S Nova Rd
Ormond Beach, FL 32174-6138
Phone (386) 671-4337

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Halifax Healthcare Systems Inc Family Medicine CurrentSince Aug 8, 2020 Accepting new patients
Florida Health Care Plan, Inc CurrentSince Jul 12, 2021 Accepting new patients
Florida Health Care Plan, Inc CurrentSince Jul 12, 2021 Accepting new patients

Locations

201 N Clyde Morris Blvd
Ste 200
Daytona Beach, FL 32114
Phone (386) 254-4165

303 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 425-2285

461 S Nova Rd
Ormond Beach, FL 32174
Phone (386) 671-4337

775 W Granada Blvd
Ste 102
Ormond Beach, FL 32174
Phone (386) 672-4615

740 Dunlawton Ave
Ste 200
Port Orange, FL 32127
Phone (386) 763-1000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1528848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1811480809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "461 S NOVA RD",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321746138",
            "telephone_number": "386-671-4337",
            "fax_number": "386-671-1127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "461 S NOVA RD",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321746138",
            "telephone_number": "386-671-4337",
            "fax_number": "386-481-6182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAILLE",
        "first_name": "KYLA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-13",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "TRN27048",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME141908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ormond Beach, FL

Sources for this page

Verify at the official NPI Registry.