MISS KRISTIN M. KAMPENGA (NPI# 1548745037) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548745037 |
| Entity Type | Individual |
| Full Name | MISS KRISTIN M. KAMPENGA |
| Credential | PA-C, MPH |
| Practice Address |
1251 Hickory St Melbourne FL 32901-3221 |
| Mailing Address |
3300 S Fiske Blvd Rockledge FL 32955-4306 |
| Practice Telephone | 3214343420 |
| Practice Fax Number | 3214343423 |
| Mailing Telephone | 3214343420 |
| Mailing Fax Number | 3219517408 |
| Enumeration Date | 2018-10-01 |
| Last Update Date | 2020-09-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA9111626 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 101537200 | 05 | |
| FL | MEDICARE HFMG | KM444 | 01 |
| FL | MEDICARE HFPSI | KN334 | 01 |
| Street Address |
1251 HICKORY ST |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32901-3221 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851347678 | Rafael Allende | Neurological Surgery | 1251 Hickory St, Melbourne, FL 32901-3221 | 2006-05-25 |
| 1245492040 | Denise Michele Holloway | Nurse Practitioner | 1251 Hickory St, Melbourne, FL 32901-3221 | 2008-07-02 |
| 1669564217 | Anthony J Dickerson | Physician Assistant | 1251 Hickory St, Melbourne, FL 32901-3221 | 2006-09-29 |
| 1821002684 | Wesley E Griffitt | Neurological Surgery | 1251 Hickory St, Melbourne, FL 32901-3221 | 2006-07-28 |
| 1316961915 | Active Chiropractic, LLC | Chiropractor | 1251 Hickory St, Melbourne, FL 32901-3221 | 2006-07-27 |
| 1659399129 | John M Gayden Jr. | Family Medicine | 1251 Hickory St, Melbourne, FL 32901-3221 | 2006-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467062943 | George Pappas | Anesthesiologist Assistant | 1775 W. Hibiscus Blvd., Ste 215, Melbourne, FL 32901 | 2020-08-09 |
| 1124676820 | Abbi Dell Lee | Behavioral Analyst | 3251 Engineering St, Melbourne, FL 32901 | 2019-08-27 |
| 1750856878 | Jeffrey Michael Cavanagh | Behavior Technician | 3251 Engineering Street, Melbourne, FL 32901 | 2018-10-04 |
| 1740766021 | Amanda Miller | Behavior Technician | 1885 W Hibiscus Blvd, Melbourne, FL 32901 | 2018-07-19 |
| 1396244406 | Dragen II LLC | Urology | 129 W Hibiscus Blvd Ste D, Melbourne, FL 32901 | 2018-02-03 |
| 1225550692 | Cabrit Psychotherapy Services LLC | Marriage & Family Therapist | 100 Rialto Place, Suite 700, Melbourne, FL 32901 | 2017-07-07 |
| 1487188058 | Project Response, Inc. | Clinic/Center | 747 S. Apollo Boulevard, Melbourne, FL 32901 | 2017-04-20 |
| 1184174575 | Paulette Swanson | Physical Therapist | 611 East Sheridan Rd, Melbourne, FL 32901 | 2016-10-10 |
| 1841747839 | Nicholas Wilson | Social Worker | 3661 S. Babcock St., Melbourne, FL 32901 | 2016-09-07 |
| 1467804278 | Nickolas Hetherington | Occupational Therapist | 1900 S Harbor City Blvd Ste 108, Melbourne, FL 32901 | 2016-07-05 |
| Find all providers in zip 32901 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760888283 | Michael Dancy | Physician Assistant | 749 Mcdermott Ave, Melbourne, FL 32935-3038 | 2014-11-11 |
| 1164833240 | Stephen Schmoll | Physician Assistant | 205 E Nasa Blvd Fl 1, Melbourne, FL 32901-1950 | 2014-05-12 |
| 1174945521 | Dale P Greyslak Pa Pllc | Physician Assistant | 700 Jordan Blass Dr, Melbourne, FL 32940-1817 | 2014-01-19 |
| 1114163144 | Melissa L Hoppe | Physician Assistant | 3021 W Eau Gallie Blvd Ste 103, Suite 440, Melbourne, FL 32934-7005 | 2008-12-22 |
| 1144376088 | Carrie M Chapman | Physician Assistant | 1223 Gateway Dr Ste 2a, Melbourne, FL 32901-2607 | 2007-01-25 |
| 1972673184 | Physician Assistant Services of Florida LLC | Physician Assistant | 301 E Hibiscus Blvd, Melbourne, FL 32901-3105 | 2006-11-08 |
| 1013097567 | Miami First Assist, LLC | Physician Assistant | 1600 Sarno Road, Suite 15, Melbourne, FL 32935 | 2006-10-17 |
| 1336151067 | Bradley A Kramer | Physician Assistant | 8725 N Wickham Rd Ste 301, Melbourne, FL 32940-2240 | 2006-08-12 |
| 1649206517 | Eduardo Batista | Physician Assistant | 1600 Sarno Rd Ste 15, Melbourne, FL 32935-4990 | 2006-06-23 |
| 1114476298 | Lisa Novak | Physician Assistant | 1600 Sarno Rd Ste 15, Melbourne, FL 32935-4990 | 2016-09-29 |
| Find all providers in MELBOURNE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.