Active NPI
Kelly Ann Fiorello, MPT
- Physical Therapist
- Gainesville, FL
National Provider Identifier
1114071503
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 22204
- Practice address
- 4820 Newberry Road
Gainesville, FL 32607 - Phone
- (352) 373-2116
- Fax
- (352) 373-1507
- NPI assigned
- Jan 22, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 22204 | FL | Primary |
Addresses
Primary practice location
4820 Newberry Road
Gainesville, FL 32607
Mailing address
607 SW 83Rd Terrace
Gainesville, FL 32607
Phone (352) 332-6818
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 |
|---|---|---|---|
| 22204 | FL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Request Physical Therapy | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapist
- Gainesville, FL
- NPI 1245225085
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114071503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "607 SW 83RD TERRACE",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "32607",
"telephone_number": "352-332-6818"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4820 NEWBERRY ROAD",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "32607",
"telephone_number": "352-373-2116",
"fax_number": "352-373-1507"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FIORELLO",
"first_name": "KELLY",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "MPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "22204",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gainesville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.