Michael T Kelly DC PA

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH0007060 Issued in FL

Legal business name

MICHAEL T KELLY DC PA

Practice address

1295 SE Port St Lucie Blvd
Port St Lucie, FL 34952-5365

Phone

(772) 785-8500

Fax

(772) 785-8511

NPI assigned

Aug 28, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Michael T Kelly, D.CNPI 1982756441

Title

Owner

Phone

(772) 785-8500

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Timothy Kelly, D.C.

  • Chiropractor
  • Port Saint Lucie, FL
  • NPI 1982756441
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1346112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740528000000",
    "number": "1053669788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1295 SE PORT ST LUCIE BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349525365",
            "telephone_number": "772-785-8500",
            "fax_number": "772-785-8511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1295 SE PORT ST LUCIE BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349525365",
            "telephone_number": "772-785-8500",
            "fax_number": "772-785-8511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL T KELLY DC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-28",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "772-785-8500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH0007060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael a Garvin, DPM, PA
• Michael Bessos MD PA
• Michael Papa, D.C., P.a.
• Michael Papa, D.C.,P.a.
• Michael Papa,D.C.,P.a.
• Beredyne Michel
• Juliette Michel
• Beran D Miclisse
• Mid-Florida Anesthesia Associates, Inc.
• Mid-Florida Radiation Oncology PA

• Chiropractor in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.