Individual provider Active NPI

Kalaundra Johnson, ARNP

  • Family Nurse Practitioner
  • Orange Park, FL
National Provider Identifier
1821593252
Registry record updated Mar 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9195782 Issued in FL
Practice address
2001 Kingsley Ave
Orange Park, FL 32073-5156
Phone
(904) 639-3971
NPI assigned
Mar 27, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9195782 FL Primary

Addresses

Primary practice location

2001 Kingsley Ave
Orange Park, FL 32073-5156

Mailing address

2001 Kingsley Ave
Orange Park, FL 32073-5156
Phone (904) 639-3971

Other practice location 1

6477 103rd St
Jacksonville, FL 32210-7129
Phone (904) 772-3300

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
I20180821001838 FL Practitioner - Nurse Practitioner 0840549093 Reassigns benefits to 3 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
Paragon Emergency Services LLCGroup PAC ID 8628153087, 401 clinicians

Practice addresses (Care Compare)

611 Zeagler Dr
Palatka, FL 32177-3810
Phone (800) 424-3672

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9195782FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Oliver Emergency Group, LLC CurrentSince Jun 25, 2024 Accepting new patients
Avecina Medical, PA CurrentSince Jul 10, 2023 Accepting new patients
Avecina Medical PA CurrentSince Jul 10, 2023 Accepting new patients
Lake Oliver Emergency Group, LLC Current Accepting new patients
Paragon Emergency Services LLC CurrentSince Jun 27, 2018 Accepting new patients
Inpatient Consultants of Florida, Inc CurrentSince Feb 1, 2024 Accepting new patients
Inpatient Consultants of Florida Inc CurrentSince Feb 1, 2024 Accepting new patients
Inpatient Consultants of Florida, Inc Current Accepting new patients
Lake Oliver Emergency Group, LLC CurrentSince Jun 25, 2024 Accepting new patients

Locations

4815 Sweetgrass Pl
Unit 201
Jacksonville, FL 32224
Phone (904) 367-3372

6477 103rd St
Jacksonville, FL 32210
Phone (904) 639-8517

3625 University Blvd S
Jacksonville, FL 32216
Phone (904) 333-9404

1633 Race Track Rd
Ste 1
Jacksonville, FL 32259
Phone (904) 230-6988

2001 W 68th St
Miami Lakes, FL 33016
Phone (305) 364-2151

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

2001 Kingsley Ave
Orange Park, FL 32073
Phone (904) 215-7015

611 Zeagler Dr
Palatka, FL 32177
Phone (386) 326-8070

23186 Blue Star Hwy
Quincy, FL 32351
Phone (850) 875-5977

1633 Race Track Rd
Ste 101
St Johns, FL 32259
Phone (904) 230-6988

2626 Capital Medical Blvd
Tallahassee, FL 32308
Phone (850) 325-5000

2674 Capital Cir SE
Tallahassee, FL 32311
Phone (850) 325-5888

3030 W Bearss Ave
Tampa, FL 33618
Phone (813) 932-2222

1451 El Camino Real
The Villages, FL 32159
Phone (352) 751-8000

Organizations & group practices 9

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": "1522108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522108800000",
    "number": "1821593252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 KINGSLEY AVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735156",
            "telephone_number": "904-639-3971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 KINGSLEY AVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735156",
            "telephone_number": "904-639-3971"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6477 103rd St",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322107129",
            "country_code": "US",
            "telephone_number": "904-772-3300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KALAUNDRA",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-27",
        "last_updated": "2018-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9195782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

Verify at the official NPI Registry.