Kelly L Deboer, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME154684 Issued in FL

Practice address

2910 Brownwood Blvd
The Villages, FL 32163-2032

Phone

(352) 674-1790

Fax

(352) 674-8990

NPI assigned

Apr 4, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Kelly L Dawson Former name

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

University of Cincinnati College of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Villages Health System LLCGroup PAC ID 2163667288, 146 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kelly.deboer.1@18324.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/18324/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Villages Health System LLC

  • General Practice Physician
  • The Villages, FL
  • NPI 1699012922
  Medicare reassignment Care Compare group NPD
• Centerwell Senior Primary Care Vitality Inc

  • Internal Medicine Physician
  • The Villages, FL
  • NPI 1730076621

  Family Medicine

  Medicare reassignment NPD
• Centerwell Senior Primary Care Vitality Inc

  • Internal Medicine Physician
  • The Villages, FL
  • NPI 1457223406

  Family Medicine

  NPD
• Centerwell Senior Primary Care Vitality Inc

  • Internal Medicine Physician
  • The Villages, FL
  • NPI 1740152792

  Family Medicine

  NPD
• Provident Senior Health, Inc.

  • Internal Medicine Physician
  • Englewood, CO
  • NPI 1780640169
  NPD (past)

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755129600000",
    "number": "1023070257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 LAKE SUMTER LNDG",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321622699",
            "telephone_number": "352-674-8905",
            "fax_number": "352-674-8901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2910 BROWNWOOD BLVD",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321632032",
            "telephone_number": "352-674-1790",
            "fax_number": "352-674-8990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBOER",
        "first_name": "KELLY",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-04",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME154684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "DAWSON",
            "middle_name": "L",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Julie Kay Davisson, APRN, PMHNP-BC
• Rosa De Carvalho, MD
• Duany De la Cruz, PT
• Deak-N-Hall, LLC
• Jordan Deboer, LCSW
• Debra a Brown LCSW Inc
• Kristin N Debusk, FNP
• Melanie Deeley, RDH
• Gerard Deib
• Delcare, PA

• Family Medicine Physician in The Villages, FL
• Providers in The Villages, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.