Kelly Desir

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

PSI38194 Issued in FL

Practice address

4501 NW 31St Ave
Oakland Park, FL 33309-3403

Phone

(754) 223-7701

NPI assigned

Dec 28, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• PGRX Wellness

  • Multi-Specialty Clinic/Center
  • Oakland Park, FL
  • NPI 1992578611
  NPD
• Phytogenics LLC

  • Community/Retail Pharmacy
  • Oakland Park, FL
  • NPI 1356508980
  NPD

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

{
    "created_epoch": "1609113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609113600000",
    "number": "1104413905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10234 ISLE WYND CT",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334375501",
            "telephone_number": "561-389-1155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 NW 31ST AVE",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333093403",
            "telephone_number": "754-223-7701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESIR",
        "first_name": "KELLY",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-28",
        "last_updated": "2020-12-28",
        "certification_date": "2020-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "PSI38194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "app.kareo.com",
            "affiliation": "N",
            "endpointDescription": "Karen ehr",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4501 NW 31st Ave",
            "city": "Oakland Park",
            "state": "FL",
            "country_code": "US",
            "postal_code": "333093403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Chevella Dennis
• Ruth Denord
• Dentists of Oakland Park PA
• Dept of Veteran Affairs
• Derrick Bowling MD PA
• Alberto Quintin Despaigne, DDS
• Michel-Ange Edouard Destine
• Marie Desvarennes, TT
• Determined Care
• Determined Care Home Health

• Student in an Organized Health Care Education/Training Program in Oakland Park, FL
• Providers in Oakland Park, FL by specialty
• Student in an Organized Health Care Education/Training Program in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2020; 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.