Kelly Jo Fredricks, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH11311 Issued in FL

Practice address

1290 Palmetto Ave
Winter Park, FL 32789-4950

Phone

(407) 647-2220

Fax

(407) 647-2221

NPI assigned

Sep 8, 2014

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Kelly Jo Telsrow Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1410134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410134400000",
    "number": "1013318138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1290 PALMETTO AVE",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327894950",
            "telephone_number": "407-647-2220",
            "fax_number": "407-647-2221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1290 PALMETTO AVE",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327894950",
            "telephone_number": "407-647-2220",
            "fax_number": "407-647-2221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDRICKS",
        "first_name": "KELLY",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-08",
        "last_updated": "2014-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH11311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "TELSROW",
            "middle_name": "JO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Frank Stieg, M.D., P.a.
• Jessica Frank, MSW
• Jacek Frankowicz, PHARM.D
• Franz Lucas & Bernstein MD PA
• Jennifer Beth Franz, MA, CCC-SLP
• Cinthya Freeborn, MSW
• Makena Freeman
• Mark Stanley Freeman, LMHC LMFT NCC ACS
• Marlee Freeman
• Sari Freeman, LCSW

• Chiropractor in Winter Park, FL
• Providers in Winter Park, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.