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Kellie Jean Fortner , ARNP

Nurse Practitioner - Family β€’ St Augustine, FL

Active NPI 1306190319 Individual Practitioner Female Practitioner
Practice location in NPPES

400 Health Park Blvd, Ste 300
St Augustine, FL 320865784

Call 9048195155 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

400 Health Park Blvd
Ste 300

St Augustine, FL 320865784

Telephone 9048195155
Organization at the Same NPPES Address or Phone
Emergency Physicians Of St. Johns County Facility NPI 1801881818

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Industry payments (Open Payments)

No Open Payments records are listed for this clinician for 2021–2025.

Guide: How to read an Open Payments record

NPI first issued

2012

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians, CMS release of October 2, 2026; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians, CMS release of October 2, 2026.

Guide: How Medicare covers telehealth

Compared with the same specialty in St Augustine and Florida

72 active clinicians are listed under Nurse Practitioner - Family with a practice address in St Augustine, FL (22,908 in Florida).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in St Augustine

5.6% of these 72 clinicians have the CMS telehealth indicator.

44.4% of these 72 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS release of October 2, 2026, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Nurse Practitioner - Family Primary Specialty

NUCC Taxonomy Code: 363LF0000X

License # reported to NPPES FL ARNP9266139
Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Florida Department of Health Medical Quality Assurance.
Look Up on State Board Site

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid ID
008049800 (FL)
Other Identifier Railroad
P01160791 (FL)
Other Identifier Bcbs
Y0F42 (FL)

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

26 listed
Dr. David Ballack , DO

Psychiatry & Neurology - Psychiatry

NPI 1386134419

Doctor of Osteopathic Medicine (D.O.)

Eli Billeter

Nurse Practitioner - Family

NPI 1063817948
Dr. Todd Broder , MD

Psychiatry & Neurology - Psychiatry

NPI 1699849349

Doctor of Medicine (M.D.)

Dr. David Cabezas , MD

Family Medicine

NPI 1063547677

Doctor of Medicine (M.D.)

Dr. Erin Coletti , DO

Internal Medicine

NPI 1639733983

Doctor of Osteopathic Medicine (D.O.)

Lidia Dalessandro , APRN

Nurse Practitioner

NPI 1700268992

Advanced Practice Registered Nurse

Career & Practice History

NPI enumerated October 30, 2012.

No changes to the name, practice address, taxonomy or NPI status in this record have been observed in the monthly NPPES data files from January 2017 to November 2026.

No reviews have been published yet. Leave a review.

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

Other Nurse Practitioner - Family Specialists in St Augustine

All Nurse Practitioner - Family Specialists in St Augustine

Mailing Address

400 Health Park Blvd, Ste 300

St Augustine, FL 320865784

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.