Kellie Standorf

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT17509 Issued in FL

Practice address

3033 Sarno Rd
Melbourne, FL 32934-7229

Phone

(321) 255-9200

NPI assigned

Oct 9, 2016

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1475971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495497600000",
    "number": "1033669502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3361 TITANIC CIR",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329031869",
            "telephone_number": "407-595-3096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 SARNO RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329347229",
            "telephone_number": "321-255-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANDORF",
        "first_name": "KELLIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-09",
        "last_updated": "2017-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT17509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Homer Phillips Stall, MD
• Brianna Stallings, MA, LMHC
• Carissa Stallings, DC
• Jeffrey Stalnaker, MD
• Nikolay Stamboliyski, MD
• Matthew Stanford, RBT
• Christian Anthony Staniec, PA-C
• Keela Ramsey Stanley, PA-C
• Courtney Stansell
• Jacquelynn Nichole Stansell

• Occupational Therapist in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2017; 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.