Individual provider Active NPI

Kareen Kaye Evans, APRN

  • Family Nurse Practitioner
  • Davenport, FL
National Provider Identifier
1861202376
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11036963 Issued in FL
Practice address
253 Grand Reserve Dr
Davenport, FL 33837-5204
Phone
(407) 516-6823
Fax
(407) 537-6100
NPI assigned
Jan 8, 2025
Last updated
Jan 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

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 APRN11036963 FL Primary

Addresses

Primary practice location

253 Grand Reserve Dr
Davenport, FL 33837-5204

Mailing address

253 Grand Reserve Dr
Davenport, FL 33837-5204
Phone (407) 516-6823

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
I20250204003806 FL Practitioner - Nurse Practitioner 6901826908 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mobile Physicians Team, LLCGroup PAC ID 0345585261, 5 clinicians

Practice addresses (Care Compare)

1225 Havendale Blvd NW
Winter Haven, FL 33881-1349
Phone (863) 298-6717

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11036963FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kopa LLC CurrentSince May 1, 2025 Accepting new patients
Mobile Physicians Team LLC CurrentSince Jun 14, 2025 Accepting new patients
Manubens Comprehensive Clinic LLC CurrentSince Jan 2, 2025 Accepting new patients
Kayemed LLC Family CurrentSince Jan 12, 2025 Accepting new patients

Locations

294 Patterson Rd
Ste B
Haines City, FL 33844
Phone (407) 467-1036

2000 N Semoran Blvd
Orlando, FL 32807
Phone (407) 641-5400

5900 Lk Ellenor Dr
Ste 700
Orlando, FL 32809
Phone (407) 216-0101

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

Hospital & facility affiliations 5

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": "1736294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1861202376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "253 GRAND RESERVE DR",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338375204",
            "telephone_number": "407-516-6823",
            "fax_number": "407-537-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "253 GRAND RESERVE DR",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338375204",
            "telephone_number": "407-516-6823",
            "fax_number": "407-537-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "KAREEN",
        "middle_name": "KAYE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-08",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11036963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, FL

Sources for this page

Verify at the official NPI Registry.