Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1306190319 Individual Practitioner Female Practitioner

Kellie Jean Fortner , ARNP

Nurse Practitioner - Family • St Augustine, FL

Professional Overview & Biography Verified Profile Summary

Kellie Fortner, ARNP is a registered healthcare professional specializing in Nurse Practitioner - Family in St Augustine, FL. Practice services are available at 400 HEALTH PARK BLVD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

400 Health Park Blvd
Ste 300

St Augustine, FL 320865784

Telephone 9048195155
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner - Family in St Augustine, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 9.6 Yrs
State Avg: 8.1 Yrs
Regional Practice Density
74 Specialists

Practicing in St Augustine, FL (22518 Statewide)

Telehealth Adoption Rate
10.8% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Nurse Practitioner - Family Primary Specialty

NUCC Taxonomy Code: 363LF0000X

State License FL ARNP9266139

Definition to come...

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
008049800 (FL)
Commercial Insurance / Payer ID Railroad
P01160791 (FL)
Commercial Insurance / Payer ID Bcbs
Y0F42 (FL)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Emily Mccarthy

Nurse Anesthetist, Certified Registered

NPI 1043188824
Dr. David Cabezas , MD

Family Medicine

NPI 1063547677

Doctor of Medicine (M.D.)

Eli Billeter

Nurse Practitioner - Family

NPI 1063817948
Wendy Lantz , APRN

Nurse Practitioner - Family

NPI 1093466526

Advanced Practice Registered Nurse

Dr. Robert Olds , MD

Psychiatry & Neurology - Psychiatry

NPI 1164573663

Doctor of Medicine (M.D.)

Dr. Edrick Lugo Millan , MD

Radiology - Diagnostic Radiology

NPI 1194178673

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active June 17, 2013

NPI status registered as active in NPPES database

📍
Updated Practice Location June 17, 2013

Registered at 400 HEALTH PARK BLVD, STE 300, ST AUGUSTINE, FL 320865784 (Tel: 9048195155)

📍
Updated Business Mailing Address June 17, 2013

Registered at 400 HEALTH PARK BLVD, STE 300, ST AUGUSTINE, FL 320865784

👤
Provider Name / Credentials Updated June 17, 2013

Recorded as KELLIE FORTNER, A.R.N.P.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 17, 2013

Nurse Practitioner (License #ARNP9266139 in FL)

🟢
Initial NPI Registration & Enumeration October 30, 2012

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1306190319
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 30, 2012
Last Update: June 17, 2013
Sole Proprietor: No

Mailing Address

400 Health Park Blvd, Ste 300

St Augustine, FL 320865784

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.