Active NPI
Kelley R Shackelford, MD
- Internal Medicine Physician
- Orlando, FL
National Provider Identifier
1083118459
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- ME147661
- Practice address
- 21 Columbia St Ste 201
Orlando, FL 32806-1133 - Phone
- (321) 841-6600
- NPI assigned
- Mar 21, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Internal Medicine Physician | 207R00000X | ME147661 | FL | Primary |
Addresses
Primary practice location
21 Columbia St Ste 201
Orlando, FL 32806-1133
Mailing address
21 Columbia St Ste 201
Orlando, FL 32806-1133
Phone (321) 841-6600
Other practice location 1
68 W Underwood Street
Suite 100
Orlando, FL 32806
Phone (954) 536-8335
Other names 1
- Dr. Kelley Rojas
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Florida State University College of Medicine, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
21 Columbia St
Orlando, FL 32806-1133
Phone (321) 841-6600
Hospital & facility affiliations
- Concierge Home Care
- Orlando Health
- Adventhealth Orlando
- Orlando Health South Lake Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME147661 | FL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orlando Health, Inc. | Current | Accepting new patients | |
| Orlando Physicians Network Inc | Internal Medicine | Current | Accepting new patients |
Locations
21 Columbia St
Ste 201
Orlando, FL 32806
Phone (321) 841-0746
21 Columbia St
Orlando, FL 32806
Phone (321) 841-5560
Interoperability endpoints
- kshackelford33502@orlandohealth.medalliesdirect.net
Organizations & group practices 2
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.
-
- Internal Medicine Physician
- Orlando, FL
- NPI 1568693554
-
- General Acute Care Hospital
- Orlando, FL
- NPI 1184709057
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Orlando, FL
- NPI 1306938071
-
- Clinical Medical Laboratory
- Orlando, FL
- NPI 1801569728
Hospital
-
- Home Health Agency
- Heathrow, FL
- NPI 1487252185
-
- General Acute Care Hospital
- Orlando, FL
- NPI 1184709057
-
- General Acute Care Hospital
- Clermont, FL
- NPI 1336221019
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1521590400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623801600000",
"number": "1083118459",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 COLUMBIA ST STE 201",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328061133",
"telephone_number": "321-841-6600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21 COLUMBIA ST STE 201",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328061133",
"telephone_number": "321-841-6600"
}
],
"practiceLocations": [
{
"address_1": "68 W Underwood Street",
"address_2": "Suite 100",
"address_purpose": "LOCATION",
"city": "Orlando",
"state": "FL",
"postal_code": "32806",
"country_code": "US",
"telephone_number": "954-536-8335",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHACKELFORD",
"first_name": "KELLEY",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-03-21",
"last_updated": "2021-06-16",
"certification_date": "2021-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "ME147661",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KELLEY",
"last_name": "ROJAS",
"prefix": "DR.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2021; 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.