Kayleigh Fallon, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APRN11015792 Issued in FL

Practice address

60 Memorial Medical Pkwy
Palm Coast, FL 32164-5980

Phone

(386) 864-4865

NPI assigned

Jan 23, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1642896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642896000000",
    "number": "1902558703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 SEDGEFIELD PATH S",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321644422",
            "telephone_number": "386-864-4865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 MEMORIAL MEDICAL PKWY",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321645980",
            "telephone_number": "386-864-4865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALLON",
        "first_name": "KAYLEIGH",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-23",
        "last_updated": "2022-01-23",
        "certification_date": "2022-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11015792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• F R Fruehan Family Practice Inc
• Richard Fabian, M.D.
• Arcangelo Faiella
• Faithangel Corp
• Joel Robert Fallon
• Kelsea Fallon
• Family Care of Palm Coast PA
• Family Eye Care of Palm Coast, Inc
• Family First Coaching, LLC
• Family Medical Care of Palm Coast LLC

• Nurse Practitioner in Palm Coast, FL
• Providers in Palm Coast, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.