Individual provider Active NPI

Amanda A Kelvey, D.O.

  • Family Medicine Physician
  • Lady Lake, FL
National Provider Identifier
1083064026
Registry record updated Dec 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS22822 Issued in FL
Practice address
201 Lagrande Blvd
Lady Lake, FL 32159-1303
Phone
(352) 753-0606
Fax
(352) 753-0650
NPI assigned
Jun 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS22822 FL Primary
Family Medicine Physician 207Q00000X 278717 MA

Addresses

Primary practice location

201 Lagrande Blvd
Lady Lake, FL 32159-1303

Mailing address

201 Lagrande Blvd
Lady Lake, FL 32159-1303
Phone (352) 753-0606

Other practice location 1

827 American Legion Hwy
Westport, MA 02790-4128
Phone (508) 636-5101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190815003049 MA Practitioner - Family Practice 4587958152 Reassigns benefits to 1 organization
I20251112001952 FL Practitioner - Family Practice 4587958152 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Physicians Network IncGroup PAC ID 7719026251, 231 clinicians

Practice addresses (Care Compare)

201 Lagrande Blvd
Lady Lake, FL 32159-1303
Phone (352) 753-0606

Hospital & facility affiliations

  • Southcoast Visiting Nurse Association Inc Home health agency, Fairhaven, MA, CCN 227101
  • Southcoast Hospitals Group Hospital, Fall River, MA, CCN 220074

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS22822FLMDFamily Medicine Physician
278717MAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southcoast Physicians Group, Inc. CurrentSince Nov 20, 2023 Accepting new patients
Orlando Physicians Network Inc Family Medicine CurrentSince Jan 1, 2026 Accepting new patients
Southcoast Physicians Group, Inc. Family Medicine CurrentSince Nov 20, 2023 Accepting new patients
Southcoast Physicians Group, Inc. Family Medicine Current Accepting new patients

Locations

21 Columbia St
Orlando, FL 32806
Phone (321) 841-5560

201 Lagrande Blvd
The Villages, FL 32159
Phone (352) 753-0606

534 Prospect St
Fall River, MA 02720
Phone (508) 679-7766

387 Quarry St
Ste 100
Fall River, MA 02723
Phone (508) 679-8111

827 American Legion Hwy
Westport, MA 02790
Phone (508) 636-5100

Interoperability endpoints

  • Direct secure messaging: akelvey47300@direct.southcoast.org

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1466467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765497600000",
    "number": "1083064026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 LAGRANDE BLVD",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321591303",
            "telephone_number": "352-753-0606",
            "fax_number": "352-753-0650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 LAGRANDE BLVD",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321591303",
            "telephone_number": "352-753-0606",
            "fax_number": "352-753-0650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "827 American Legion Hwy",
            "address_purpose": "LOCATION",
            "city": "Westport",
            "state": "MA",
            "postal_code": "027904128",
            "country_code": "US",
            "telephone_number": "508-636-5101",
            "fax_number": "508-636-3651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELVEY",
        "first_name": "AMANDA",
        "middle_name": "A",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-21",
        "last_updated": "2025-12-12",
        "certification_date": "2025-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS22822",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "278717",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lady Lake, FL

Sources for this page

Verify at the official NPI Registry.