Physician Compare National (NPI:1740586288)

HEALTHCARE PROVIDER: KELLIE KILPATRICK BATTILLO FNP-C, ARNP

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1740586288
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4183056021
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20191115000545
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BATTILLO
	Individual professional last name
Provider First Name	KELLIE
	Individual professional first name
Provider Middle Name	KILPATRICK
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2017
	Individual professional's medical school graduation year
Primary Specialty	NURSE PRACTITIONER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	76 S ST ANDREWS DR
	Group Practice or individual's line 1 address
City	ORMOND BEACH
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	321743857
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	100014
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	FLORIDA HOSPITAL NEW SMYRNA
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	100028
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	PARRISH MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y