DR. KIERSTEN LEA PRINCE D.O.
NPI 1467689174
Family Medicine in Callahan, FL

Q: What is Kiersten Prince's NPI number?

The NPI number for Kiersten Prince is 1467689174. It was assigned to this individual provider in the NPPES registry on June 20, 2009.

Q: What is Kiersten Prince's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Kiersten Prince was last updated on December 28, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 20, 2009PECOS EnrolledAccepts Medicare Assignment

91.62/100

CMS Quality Rating

45465 FIFTH AVE, CALLAHAN, FL 32011(904) 879-4544(904) 879-4411 Get Directions Write a Review

NPPES record last updated: December 28, 2018. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 28, 2018, Nov 16, 2015, Nov 12, 2015 (3 updates tracked since 2015).

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About Dr. Kiersten Lea Prince D.o. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KIERSTEN LEA PRINCE D.O. (NPI 1467689174) is an individual family medicine provider in Callahan, Florida, licensed in Florida (OS11823) and active in the NPI registry since June 2009. She is enrolled in Medicare PECOS, is affiliated with Shands Jacksonville, and is a graduate of Other (2009).

NPPES Registry Identity

NPI1467689174

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameDR. KIERSTEN LEA PRINCECredential: D.O.

Location Address45465 FIFTH AVECallahan, FL 32011-3901

Mailing AddressPo Box 45443Salt Lake City, UT 84145-0443 · (904) 202-1032 · Fax (904) 376-4107

Phone(904) 879-4544

Fax(904) 879-4411

Sole ProprietorNo

Medical School CMSOtherGraduated 2009

Enumeration DateJune 20, 2009

Last NPPES UpdateDecember 28, 20183 updates tracked since enumeration

✔ NPI 1467689174 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in FL · OS11823

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

45465 FIFTH AVE, Callahan, FL 32011

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Other Identifiers 1

OtherP01201601FL · Railroad Medicare

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Kiersten Lea Prince D.o. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9436309952

PECOS Enrollment IDI20121018000469

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Kiersten Prince reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Baptist Primary Care Inc

Same address

Family Medicine

45465 5TH AVE
Callahan, FL 32011

Reassigned Medicare billing, Florida enrollment
569 clinicians in this Medicare group

NPI 1457532400 (904) 879-4544

Emergency Physicians Inc

19 mi

Emergency Medicine

800 PRUDENTIAL DR
Jacksonville, FL 32207

Reassigned Medicare billing, Florida and Georgia enrollments
Also billed through NPI 1477001972 (Georgia)
428 clinicians in this Medicare group

NPI 1285686675 (904) 396-5682

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 7

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Removal of skin and tissue, 20.0 sq cm or less 11042

This procedure involves the surgical removal of skin and tissue, up to 20.0 square cm in size. It's often performed to treat conditions like skin cancer or to remove moles, warts, and other skin lesions. The area is numbed and the unwanted tissue is carefully cut out.

175 services49 patients

Emergency department visit with high level of medical decision making 99285

An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.

128 services128 patients

Emergency department visit with moderate level of medical decision making 99284

An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.

104 services102 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

40 services19 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

19 services19 patients

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

19 services19 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Shands Jacksonville

Acute Care Hospitals · Jacksonville, FL

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100001

Location655 W 8th StJacksonville, FL 32209 · Duval County

Emergency services Birthing friendly

Baptist Health Medical Center - Jacksonville

Acute Care Hospitals · Jacksonville, FL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100088

Location800 Prudential DrJacksonville, FL 32207 · Duval County

Emergency services Birthing friendly

Baptist Medical Center - Nassau

Acute Care Hospitals · Fernandina Beach, FL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100140

Location1250 S 18th StFernandina Beach, FL 32034 · Nassau County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32011 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$87.62 typical visit price

range $56.00 – $171.84

Typical copayment $21.90 (range $14.00 – $42.96)

Most-billed visit code 99203

Established Patient

$99.16 typical visit price

range $17.57 – $139.16

Typical copayment $24.79 (range $4.39 – $34.79)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

91.62/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

77.61

Promoting Interoperability

100

Improvement Activities

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

STEPHANIE ANN MAY APRN

Nurse Practitioner

45465 FIFTH AVE
CALLAHAN, FL 32011

Nassau County (904) 879-4544

GARRETT D CUDMORE DO

Family Medicine

45465 FIFTH AVE
CALLAHAN, FL 32011

Nassau County (904) 879-4544

DR. WARREN S GROFF MD

Family Medicine

45465 FIFTH AVE, CREDENTIALING DEPARTMENT
CALLAHAN, FL 32011

Nassau County (904) 879-4544

SHANNON MARIE CISLO PA-C

Physician Assistant

45465 FIFTH AVE
CALLAHAN, FL 32011

Nassau County (904) 879-4544

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kiersten Prince's NPI number?

The NPI number for Kiersten Prince is 1467689174. It was assigned to this individual provider in the NPPES registry on June 20, 2009.

Where is Kiersten Prince located?

Kiersten Prince practices at 45465 Fifth Ave, Callahan, FL 32011. The listed phone number is (904) 879-4544.

What is Kiersten Prince's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Kiersten Prince enrolled in Medicare?

Yes. Kiersten Prince is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Kiersten Prince's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kiersten Prince reassigns Medicare benefits to 2 organizations: Baptist Primary Care Inc (Callahan, FL) and Emergency Physicians Inc (Jacksonville, FL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kiersten Prince's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Kiersten Prince affiliated with any hospitals?

According to CMS data, Kiersten Prince is affiliated with Shands Jacksonville, Baptist Health Medical Center - Jacksonville and Baptist Medical Center - Nassau.

When was this NPI record last updated?

The NPPES record for Kiersten Prince was last updated on December 28, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.