Individual provider

Krysta Clark, NP

Gerontology Nurse Practitioner General Practice Registered Nurse Family Nurse Practitioner Medicare enrolled

Krysta Clark, NP is a Gerontology Nurse Practitioner in Winter Haven, FL, registered under NPI 1366094914. This provider registers 3 separate taxonomy codes, which usually means they practise across more than one recognised specialty.

Getting there

The practice address on file is 400 AVENUE F SE FL 1, Winter Haven, FL 33880. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.

400 AVENUE F SE FL 1, Winter Haven, FL 33880 Open in Google Maps →

Credentials and Medicare

State licence
LicenceStateSpecialty
APRN11018536 FL Gerontology Nurse Practitioner primary
544669 NY General Practice Registered Nurse
APRN11018536 FL Family Nurse Practitioner

Licences are recorded in 2 states: FL, NY. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.

Medicare (PECOS)
Status
Approved
Provider type
Practitioner - Nurse Practitioner
PAC ID
1557795580

Medicare enrolment is recorded as approved under the provider type Practitioner - Nurse Practitioner. This means the provider is enrolled to bill Medicare, though it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.

Licensed in 2 states

This provider holds licences in 2 states: Florida and New York. The practice address on file is in Winter Haven, FL, but a licence in another state usually means they see patients there too — either at a second location or by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.

FL Florida practice address
Licence
APRN11018536
Specialty
Gerontology Nurse Practitioner
Verify with the FL board →
NY New York
Licence
544669
Specialty
General Practice Registered Nurse
Verify with the NY board →

Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.

What Gerontology covers

Definition to come... NUCC Health Care Provider Taxonomy, code 363LG0600X
Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Gerontology

All registered taxonomy codes

This provider registers 3 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.

CodeSpecialtyLicenceState
363LG0600X Gerontology Nurse Practitioner Gerontology APRN11018536 FL primary
163WG0000X General Practice Registered Nurse General Practice 544669 NY
363LF0000X Family Nurse Practitioner Family APRN11018536 FL

The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.

Full NPPES record

An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.

NPI1366094914 valid check digit
Entity typeIndividual (NPI-1)
Enumeration dateJul 14, 2019
Last updatedJul 8, 2024
StatusActive
Sole proprietorNo
CredentialNP
Practice address 400 AVENUE F SE FL 1
Winter Haven, FL 33880
(727) 315-6775
Mailing address 2995 DREW ST FL 2
Clearwater, FL 33759
Other identifiers 117903900 (FL)
This record was updated on Jul 8, 2024, which is recent enough that the contact details are likely still accurate.

Number check

1366094914 passes the NPI check digit test The final digit 4 matches the value computed from the first nine digits, so this is a well-formed NPI.
How the check works, step by step

Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.

Digit 8 0 8 4 0 1 3 6 6 0 9 4 9 1
Doubled? ×2 ×2 ×2 ×2 ×2 ×2 ×2
Value 8 0 8 8 0 2 3 3 6 0 9 8 9 2

Sum = 66 · next multiple of 10 = 70 · check digit = 4 · actual last digit = 4

A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.

Common questions

What is NPI number 1366094914?
NPI 1366094914 is the National Provider Identifier assigned to Krysta Clark, NP in Winter Haven, FL. It is a 10-digit number issued by the Centers for Medicare & Medicaid Services and used on claims, referrals, and prescriptions to identify the provider.
What does Gerontology cover?
Definition to come...
How do I contact Krysta Clark, NP?
The phone number on file with NPPES is (727) 315-6775, last updated Jul 8, 2024. Because NPPES is only updated when a provider files a change, call ahead to confirm the number and the current practice address before visiting.
Does Krysta Clark, NP accept Medicare?
This NPI has an approved Medicare enrolment in PECOS, which means the provider is enrolled to bill Medicare. Enrolment does not guarantee they are accepting new Medicare patients — verify directly with the office.
Is NPI 1366094914 a valid number?
Yes. 1366094914 passes the Luhn check digit validation that CMS uses for NPI numbers, and it resolves to an active record in the registry.
How to use this page. Everything here comes from public federal records. Tips Health does not verify quality of care, confirm that a licence is currently active, or check malpractice history, and accepts no fees for placement. A listing is not a recommendation. Verify independently before seeking care.