Individual provider Active NPI

Adam M McKinnon Sr., APRN, FNP-C

  • Family Nurse Practitioner
  • Pembroke Pines, FL
National Provider Identifier
1881294775
Registry record updated Aug 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11009738 Issued in FL
Practice address
880 SW 145TH Ave Ste 202
Pembroke Pines, FL 33027-6171
Phone
(866) 849-0692
Fax
(888) 973-8821
NPI assigned
Oct 29, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2026

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3-001657 AL
Family Nurse Practitioner 363LF0000X 91348 NM
Family Nurse Practitioner 363LF0000X 1181313 TX
Family Nurse Practitioner 363LF0000X APRN.CNP.0033374 OH
Family Nurse Practitioner 363LF0000X 36524 TN
Family Nurse Practitioner 363LF0000X A193455 IA
Family Nurse Practitioner 363LF0000X APRN11009738 FL Primary

Addresses

Primary practice location

880 SW 145TH Ave Ste 202
Pembroke Pines, FL 33027-6171

Mailing address

PO Box 211699
Eagan, MN 55121-3699
Phone (866) 849-0692

Other practice location 1

1129 N Missouri Ave
Lakeland, FL 33805-4411
Phone (866) 234-8534

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, AL, TN3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20210105000085 FL Practitioner - Nurse Practitioner 0840603296 Reassigns benefits to 2 organizations
I20240418002241 AL Practitioner - Nurse Practitioner 0840603296
I20240814003095 TN Practitioner - Nurse Practitioner 0840603296 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3-001657ALMDFamily Nurse Practitioner
APRN11009738FLMDFamily Nurse Practitioner
APRN.CNP.0033374OHMDFamily Nurse Practitioner
36524TNMDFamily Nurse Practitioner
1181313TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Florida Health Care, Inc CurrentSince Dec 7, 2020 Accepting new patients
Central Florida Health Care, Inc. Current Accepting new patients
Central Florida Health Care Inc CurrentSince Dec 7, 2020 Accepting new patients
Devoted Medical Group Professional Corporation CurrentSince Mar 15, 2023 Accepting new patients

Locations

950 County Road 17A W
Avon Park, FL 33825
Phone (863) 452-3000

109 W Wall St
Frostproof, FL 33843
Phone (863) 635-4891

305 W Central Ave
Fl Heal
Lake Wales, FL 33853

1129 N Missouri Ave
Lakeland, FL 33805
Phone (863) 413-8600

880 SW 145th Ave
Ste 202
Pembroke Pines, FL 33027
Phone (615) 275-6612

1514 1st St N
Winter Haven, FL 33881
Phone (863) 291-5110

47 5th St NW
Winter Haven, FL 33881

221 Crescent St
Ste 202
Waltham, MA 02453
Phone (617) 958-1611

3200 West End Ave
Nashville, TN 37203
Phone (615) 510-1646

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.

NPI Registry JSON

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

{
    "created_epoch": "1603929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787184000000",
    "number": "1881294775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 211699",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551213699",
            "telephone_number": "866-849-0692",
            "fax_number": "888-973-8821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 SW 145TH AVE STE 202",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330276171",
            "telephone_number": "866-849-0692",
            "fax_number": "888-973-8821"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1129 N Missouri Ave",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338054411",
            "country_code": "US",
            "telephone_number": "866-234-8534",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKINNON",
        "first_name": "ADAM",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-29",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "3-001657",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "91348",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1181313",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0033374",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "36524",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A193455",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11009738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.