Kenneth R Nystrom , PA
Physician Assistant • Patrick Afb, FL
Notice of NPI Deactivation & Inactive Practice Status
According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Kenneth Nystrom has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Kenneth Nystrom, PA was a registered Physician Assistant practicing in Patrick Afb, FL. Throughout an active medical career spanning 19 years, Kenneth Nystrom provided care at the practice location at 1381 S PATRICK DR until profile deactivation on 2024-04-03.
Practice Location & Contact Primary Location
1381 S Patrick Dr
Patrick Afb, FL 329253606
Specialty Benchmarks & Practice Insights
Comparative analytics for Physician Assistant in Patrick Afb, FL
Practicing in Patrick Afb, FL (10376 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
NUCC Taxonomy Code: 363A00000X
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Practice Associates & Co-Workers
Healthcare professionals and specialists practicing at this location or sharing practice phone/fax
Physician Assistant
Physician Assistant
Physical Therapist
Physical Therapist
Dentist
Doctor of Dental Medicine
Preventive Medicine - Occupational Medicine
Doctor of Osteopathic Medicine (D.O.)
Internal Medicine
Doctor of Medicine (M.D.)
Family Medicine
Doctor of Medicine (M.D.)
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Record deactivated on April 03, 2024
NPI status registered as active in NPPES database
Registered at 1381 S PATRICK DR, PATRICK AFB, FL 329253606 (Tel: 3214948237)
Registered at 5325 CREEKWOOD DR, MELBOURNE, FL 329401492 (Tel: 3217528134)
Recorded as KENNETH NYSTROM, PA
Physician Assistant (License #PA0003444 in FL)
First registered as active Individual Practitioner in NPPES Database.
Patient & Community Reviews
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NPI Administrative Meta
Mailing Address
5325 Creekwood Dr
Melbourne, FL 329401492
Phone: 3217528134
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