Individual provider Active NPI

Katelyn Nicole Liptak, MSN, APRN, FNP-C

  • Obstetrics & Gynecology Nurse Practitioner
  • Fort Myers, FL
National Provider Identifier
1861103483
Registry record updated Dec 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
APRN11023349 Issued in FL
Practice address
6150 Diamond Centre CT
Fort Myers, FL 33912-4367
Phone
(239) 561-9191
NPI assigned
Dec 6, 2022
Last updated
Dec 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X APRN11023349 FL Primary

Addresses

Primary practice location

6150 Diamond Centre CT
Fort Myers, FL 33912-4367

Mailing address

6150 Diamond Centre CT # 400
Fort Myers, FL 33912-4367
Phone (239) 561-9191

Other practice location 1

1213 Piper Blvd Ste 201
Naples, FL 34110-1393
Phone (239) 561-9191

Other names 1

  • Katelyn Duley Former name

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
I20221220000267 FL Practitioner - Nurse Practitioner 4880063528 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11023349FLMDObstetrics & Gynecology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Women's Contemporary Health Center, PLLC CurrentSince Dec 5, 2022 Accepting new patients

Locations

6150 Diamond Centre Ct
Bldg 400
Fort Myers, FL 33912
Phone (239) 333-0828

6150 Diamond Centre Ct
Unit 400
Fort Myers, FL 33912
Phone (239) 333-3345

1213 Piper Blvd
Ste 203
Naples, FL 34110
Phone (239) 561-9191

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1670284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1861103483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6150 DIAMOND CENTRE CT # 400",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124367",
            "telephone_number": "239-561-9191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6150 DIAMOND CENTRE CT",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124367",
            "telephone_number": "239-561-9191"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1213 Piper Blvd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Naples",
            "state": "FL",
            "postal_code": "341101393",
            "country_code": "US",
            "telephone_number": "239-561-9191",
            "fax_number": "239-561-9188",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIPTAK",
        "first_name": "KATELYN",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-06",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "FL",
            "license": "APRN11023349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATELYN",
            "last_name": "DULEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.