Melody Koback

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN11002961 Issued in FL

Practice address

1200 Deltona Blvd
Suite 40a
Deltona, FL 32725-6386

Phone

(386) 202-6025

NPI assigned

Feb 23, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northeast Florida Health Services, IncGroup PAC ID 0547249518, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: melody.koback@nefhs.eclinicaldirectplus.com

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.

• Northeast Florida Health Services, Inc.

  dba Family Health Source

  • Federally Qualified Health Center (FQHC)
  • Pierson, FL
  • NPI 1992792311
  Medicare reassignment Care Compare group NPD
• VMD Primary Providers Central Florida PLLC

  • Family Medicine Physician
  • Saint Cloud, FL
  • NPI 1134738974

  Nurse Practitioner

  Medicare reassignment NPD
• Northeast Florida Health Services Inc

  dba Family Health Source

  • Federally Qualified Health Center (FQHC)
  • Deltona, FL
  • NPI 1427605534
  NPD
• VMD Primary Providers Central Florida PLLC

  • Family Medicine Physician
  • Clermont, FL
  • NPI 1780342618
  NPD (past)
• Kids and Family Kare LLC

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1508406075
  NPD (past)
• Kids Kare Pediatrics

  • Point of Service
  • Phoenix, AZ
  • NPI 1699144857
  NPD (past)

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

{
    "created_epoch": "1519344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1952802043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 S WOODLAND BLVD STE 3",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327207464",
            "telephone_number": "386-202-6025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 DELTONA BLVD",
            "address_2": "SUITE 40A",
            "city": "DELTONA",
            "state": "FL",
            "postal_code": "327256386",
            "telephone_number": "386-202-6025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOBACK",
        "first_name": "MELODY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-23",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11002961",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN11002961",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "APRN11002961",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11002961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103491600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Nichole Kiely, PT, DPT
• Anthony Kim, D.C.
• Julie Kimberly, RRT
• Althea King, MA
• Vernique King
• Alyssa Hope Kolp, COTA/L
• James M. Kornegay, DDS,MAGD,PA
• Amanda Marie Krebs, PHARMD
• Lavanya Krishnan
• Lisa Krupa, MS, LMHC

• Family Nurse Practitioner in Deltona, FL
• Providers in Deltona, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.