NPIMap

Individual provider Active NPI

Katherine Ann Becker, A.R.N.P.

  • Family Nurse Practitioner
  • New Smyrna Beach, FL
National Provider Identifier
1891003216
Registry record updated Sep 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP 9199728 Issued in FL
Practice address
275 County Road 415
New Smyrna Beach, FL 32168-8906
Phone
(386) 566-6244
NPI assigned
Sep 20, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2020

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 ARNP 9199728 FL Primary

Addresses

Primary practice location

275 County Road 415
New Smyrna Beach, FL 32168-8906

Mailing address

275 County Road 415
New Smyrna Beach, FL 32168-8906
Phone (386) 566-6244

Other names 1

  • Miss Katherine Ann Koles Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201006001268 FL Practitioner - Nurse Practitioner 4284053539 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nautilus Health Care Group LLCGroup PAC ID 5991604852, 51 clinicians

Practice addresses (Care Compare)

600 Palmetto St
Suite 5
New Smyrna Beach, FL 32168-7327
Phone (386) 424-3850

Hospital & facility affiliations

  • Trilogy Home Healthcare Home health agency, Jacksonville, FL, CCN 107689
  • Adventhealth New Smyrna Beach Hospital, New Smyrna Beach, FL, CCN 100014
  • Adventhealth Daytona Beach Hospital, Daytona Beach, FL, CCN 100068
  • Halifax Health Medical Center Hospital, Daytona Beach, FL, CCN 100017
  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP 9199728FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nautilus Health Care Group, LLC CurrentSince Nov 15, 2023 Accepting new patients
Nautilus Health Care Group LLC CurrentSince Nov 15, 2023 Accepting new patients
Advanced Wound Systems LLC Past Accepting new patients
Ormond Medical Arts Family Practice LLC Past Accepting new patients

Locations

151 E Redstone Ave
Crestview, FL 32539
Phone (850) 629-8515

1500 Lee Blvd
Lehigh Acres, FL 33936
Phone (239) 368-4410

600 Palmetto St
#5
New Smyrna Beach, FL 32168
Phone (386) 424-3850

600 Palmetto St
New Smyrna Beach, FL 32168
Phone (386) 424-3850

1120 Pinellas Bayway S
Ste 200
Tierra Verde, FL 33715
Phone (727) 867-5480

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1579/brand/8/csg/141/fhir/r4

Organizations & group practices 5

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.

Hospital & facility affiliations 7

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": "1284940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1891003216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 COUNTY ROAD 415",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321688906",
            "telephone_number": "386-566-6244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 COUNTY ROAD 415",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321688906",
            "telephone_number": "386-566-6244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKER",
        "first_name": "KATHERINE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "A.R.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-20",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP 9199728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "KOLES",
            "middle_name": "ANN",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New Smyrna Beach, FL

Sources for this page

Verify at the official NPI Registry.