Active NPI
Amber Kelly
- Personal Care Attendant
- Weatherford, TX
National Provider Identifier
1073909875
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Personal Care Attendant
- License
- 601324
- Practice address
- 119 Saddle Club Rd
Suite B
Weatherford, TX 76088-7622 - Phone
- (817) 965-4905
- Fax
- (469) 916-6740
- NPI assigned
- Apr 9, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Personal Care Attendant | 3747P1801X | 601324 | TX | Primary |
Addresses
Primary practice location
119 Saddle Club Rd
Suite B
Weatherford, TX 76088-7622
Mailing address
119 Saddle Club Rd
Suite B
Weatherford, TX 76088-7622
Phone (817) 965-4905
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 601324 | TX | MD | Personal Care Attendant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1428537600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1428537600000",
"number": "1073909875",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "119 SADDLE CLUB RD",
"address_2": "SUITE B",
"city": "WEATHERFORD",
"state": "TX",
"postal_code": "760887622",
"telephone_number": "817-965-4905",
"fax_number": "469-916-6740"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "119 SADDLE CLUB RD",
"address_2": "SUITE B",
"city": "WEATHERFORD",
"state": "TX",
"postal_code": "760887622",
"telephone_number": "817-965-4905",
"fax_number": "469-916-6740"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "AMBER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-04-09",
"last_updated": "2015-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "3747P1801X",
"taxonomy_group": "",
"desc": "Technician, Personal Care Attendant",
"state": "TX",
"license": "601324",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Weatherford, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.