Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Kelly M Bumgarner, PA-C

Individual provider Physician Assistant · NPI 1548714728

Mrs. Kelly M Bumgarner, PA-C is a Physician Assistant in Jacksonville Beach, Florida. Qualified in 2016, 10 years ago. Practices with Baptist Cardiology, Inc, a 99-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Florida.

Years since qualifying
10
Licensed in
FL
In the registry since
2016
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1320 Roberts Dr Ste 101
Jacksonville Beach, FL 32250-3253
Phone: (904) 241-7147
Fax: (904) 376-3213
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA9109484 (FL)

Record details

NPI number1548714728
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 5, 2016
Last updated in NPPESNovember 13, 2025
Certification dateNovember 13, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Baptist Cardiology, Inc. — 99 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

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