Individual provider Active NPI

Kaylyn Munroe

  • Family Nurse Practitioner
  • Clearwater, FL
National Provider Identifier
1932812765
Registry record updated Dec 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11022523 Issued in FL
Practice address
2112 Sunnydale Blvd Ste B
Clearwater, FL 33765-1207
Phone
(727) 796-2904
NPI assigned
Dec 26, 2022
Last updated
Dec 26, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2022

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 11022523 FL Primary

Addresses

Primary practice location

2112 Sunnydale Blvd Ste B
Clearwater, FL 33765-1207

Mailing address

106 E Main St
Spring Arbor, MI 49283-9701

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
I20230328000456 FL Practitioner - Nurse Practitioner 9638543960 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11022523FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Clinicare Clinical Services, Inc. CurrentSince Jan 15, 2023 Accepting new patients

Locations

2112 Sunnydale Blvd
Ste B
Clearwater, FL 33765
Phone (727) 796-2904

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": "1672012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672012800000",
    "number": "1932812765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 E MAIN ST",
            "city": "SPRING ARBOR",
            "state": "MI",
            "postal_code": "492839701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2112 SUNNYDALE BLVD STE B",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337651207",
            "telephone_number": "727-796-2904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNROE",
        "first_name": "KAYLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-26",
        "last_updated": "2022-12-26",
        "certification_date": "2022-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11022523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.