Individual provider Active NPI

Kathleen Mary Bovee, NP

  • Gerontology Nurse Practitioner
  • Melbourne, FL
National Provider Identifier
1942314265
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
11020385 Issued in FL
Practice address
6300 N Wickham Rd Ste 132a
Melbourne, FL 32940-2023
Phone
(321) 253-4032
Fax
(321) 253-4125
NPI assigned
Aug 17, 2006
Last updated
Jul 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 340436-1 NY
Gerontology Nurse Practitioner 363LG0600X R218354 MD
Gerontology Nurse Practitioner 363LG0600X 11 FL
Gerontology Nurse Practitioner 363LG0600X 11020385 FL Primary
Gerontology Nurse Practitioner 363LG0600X 340436 NY
Registered Nurse 163W00000X 482629-1 NY

Addresses

Primary practice location

6300 N Wickham Rd Ste 132a
Melbourne, FL 32940-2023

Mailing address

1344 S Apollo Blvd Ste 406
Melbourne, FL 32901-3185
Phone (321) 727-2990

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
I20220907000417 FL Practitioner - Nurse Practitioner 5092617340 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
482629-1NYMDRegistered Nurse
11FLMDGerontology Nurse Practitioner
11020385FLMDGerontology Nurse Practitioner
340436NYMDGerontology Nurse Practitioner
340436-1NYMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Omni Healthcare, Inc Current Accepting new patients
Omni Healthcare, Inc. CurrentSince Jun 1, 2024 Accepting new patients
Elyaman Medical Services PA Gerontology CurrentSince Aug 1, 2022 Accepting new patients
University of Maryland Surgcial Assoc PA Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1344 S Apollo Blvd
Ste 406
Melbourne, FL 32901
Phone (321) 253-4032

6300 N Wickham Rd
Ste 132A
Melbourne, FL 32940
Phone (321) 253-4032

6041 SW 54th St
Ste 200
Ocala, FL 34474
Phone (352) 857-8417

6100 Minton Rd NW
Ste 104
Palm Bay, FL 32907
Phone (321) 724-1172

Interoperability endpoints

  • Direct secure messaging: kathleenbovee@ohi.allscriptsdirect.net

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, 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": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1942314265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1344 S APOLLO BLVD STE 406",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013185",
            "telephone_number": "321-727-2990",
            "fax_number": "321-724-0455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 N WICKHAM RD STE 132A",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329402023",
            "telephone_number": "321-253-4032",
            "fax_number": "321-253-4125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOVEE",
        "first_name": "KATHLEEN",
        "middle_name": "MARY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-17",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NY",
            "license": "340436-1",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MD",
            "license": "R218354",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "11",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "11020385",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NY",
            "license": "340436",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "482629-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.