Kelly Duane Carter, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME149464 Issued in FL

Practice address

619 N Cove Blvd
Panama City, FL 32401-3642

Phone

(850) 804-3870

NPI assigned

Sep 14, 2006

Last updated

Sep 2, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA, FL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kcarter15192@enloedirect.org
• Direct secure messaging: kelly.carter.2@9582.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ascension Sacred Heart Gulf

  dba Ascension Medical Group Sacred Heart Gulf

  • Family Medicine Physician
  • Pensacola, FL
  • NPI 1528336302

  Pediatrics

  Medicare reassignment NPD
• Enloe Medical Center

  dba Enloe Trauma & Surgery Clinic

  • Surgery Physician
  • Chico, CA
  • NPI 1477975613
  Medicare reassignment NPD
• Ascension Sacred Heart Gulf

  dba Ascension Medical Group Sacred Heart Gulf

  • Rural Health Clinic/Center
  • Port St Joe, FL
  • NPI 1912466194
  NPD
• Enloe Medical Center

  dba Enloe Op Center Pharmacy

  • Community/Retail Pharmacy
  • Chico, CA
  • NPI 1912949538
  NPD

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1124123195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 N COVE BLVD",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324013642",
            "telephone_number": "850-804-3870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 N COVE BLVD",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324013642",
            "telephone_number": "850-804-3870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "KELLY",
        "middle_name": "DUANE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "C54560",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME149464",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AL",
            "license": "20711",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000035556",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "35556",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "C54560",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christy Carpenter, LMHC
• Kathy Carroll, ARNP
• Cathryn Carson, MS, RMHCI
• Justin Carson, PTA
• Abigail Carter
• Linda S Caruso, ARNP-C
• Kelly Carver, D.O.
• Robert Clifton Case IV, DMD
• Dixie Lynn Casford, MA, LMHC
• Dorothy Dianne Cash, NP

• Pediatrics Physician in Panama City, FL
• Providers in Panama City, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.