Individual provider Active NPI

Meredith Jill Kelly, APRN

  • Nurse Practitioner
  • Coral Springs, FL
National Provider Identifier
1114457488
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11013919 Issued in FL
Practice address
5441 N University Dr Ste 101
Coral Springs, FL 33067-4640
Phone
(954) 803-9002
Fax
(954) 933-2305
NPI assigned
Jun 19, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X APRN11013919 FL Primary

Addresses

Primary practice location

5441 N University Dr Ste 101
Coral Springs, FL 33067-4640

Mailing address

5441 N University Dr Ste 101
Coral Springs, FL 33067-4640
Phone (954) 803-9002

Other practice location 1

8395 W Oakland Park Blvd Ste E-F
Sunrise, FL 33351-7301
Phone (954) 803-9002

Other practice location 2

1414 SE 3rd Ave
Fort Lauderdale, FL 33316-1910
Phone (954) 803-9002

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240627002395 FL Practitioner - Nurse Practitioner 0941567218 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Neurology Institute, LLCGroup PAC ID 8123393881, 25 clinicians

Practice addresses (Care Compare)

1414 SE 3Rd Ave
Fort Lauderdale, FL 33316-1910
Phone (954) 803-9002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Neurology Institute, LLC Multi-Specialty CurrentSince Jun 24, 2024 Accepting new patients

Locations

5441 N University Dr
Ste 101
Coral Springs, FL 33067
Phone (954) 739-2221

1414 SE 3rd Ave
Ft Lauderdale, FL 33316
Phone (954) 764-8033

8395 W Oakland Park Blvd
Ste Ef
Sunrise, FL 33351
Phone (954) 803-9002

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22170/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/DECFCD

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.

NPI Registry JSON

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

{
    "created_epoch": "1497830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1114457488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5441 N UNIVERSITY DR STE 101",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330674640",
            "telephone_number": "954-803-9002",
            "fax_number": "954-933-2305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5441 N UNIVERSITY DR STE 101",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330674640",
            "telephone_number": "954-803-9002",
            "fax_number": "954-933-2305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8395 W Oakland Park Blvd Ste E-F",
            "address_purpose": "LOCATION",
            "city": "Sunrise",
            "state": "FL",
            "postal_code": "333517301",
            "country_code": "US",
            "telephone_number": "954-803-9002",
            "fax_number": "954-933-2305",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1414 SE 3rd Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Lauderdale",
            "state": "FL",
            "postal_code": "333161910",
            "country_code": "US",
            "telephone_number": "954-803-9002",
            "fax_number": "954-933-2305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MEREDITH",
        "middle_name": "JILL",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-19",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11013919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

Verify at the official NPI Registry.