Kelli Anne Faville, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT31721 Issued in FL

Practice address

6775 40TH Ave N
Saint Petersburg, FL 33709-4939

Phone

(727) 803-1002

NPI assigned

Mar 11, 2019

Sex

Female

Sole proprietor

Yes

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": "1552262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552262400000",
    "number": "1104384916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 1ST AVE S STE 200",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337014364",
            "telephone_number": "727-308-9848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6775 40TH AVE N",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337094939",
            "telephone_number": "727-803-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAVILLE",
        "first_name": "KELLI",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-11",
        "last_updated": "2019-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT31721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Avery Jane Fasulo
• Delaram Fatemi, MD
• Barry Faulkner
• Kim T Faulkner, MD
• Jasmine Favata
• Tarek Ali Fawaz Jr., PHARM D
• Sybil Prewitt Faylo, AU.D.
• Burnes Lynn Feaster III, MD
• Feather Touch Wound and Vein Clinic PLLC
• Helen Featherston, ARNP

• Physical Therapist in Saint Petersburg, FL
• Providers in Saint Petersburg, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2019; 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.