Kerry Kathleen Kelly, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

ARNP3097652 Issued in FL

Practice address

6261 NW 6TH Way
Suite 110
Fort Lauderdale, FL 33309-6103

Phone

(954) 634-6400

Fax

(954) 634-6444

NPI assigned

May 1, 2009

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

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Evalucare

  • General Practice Physician
  • Fort Lauderdale, FL
  • NPI 1073740106
  NPD (past)

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

{
    "created_epoch": "1241136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241136000000",
    "number": "1124262340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6261 NW 6TH WAY",
            "address_2": "SUITE 110",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333096103",
            "telephone_number": "954-634-6400",
            "fax_number": "954-634-6444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6261 NW 6TH WAY",
            "address_2": "SUITE 110",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333096103",
            "telephone_number": "954-634-6400",
            "fax_number": "954-634-6444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "KERRY",
        "middle_name": "KATHLEEN",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-01",
        "last_updated": "2009-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP3097652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Kelley
• Tara Marie Kellogg
• Kelly Rashid Rd LLC
• Donald W Kelly, LMHC
• Kathleen Kelly, MSW, LCSW
• Katrina Schiefer Kemos, LCSW
• Sonja Kempski, LMT
• Matthew M Kenick, PAC
• David Noah Kenigsberg, MD
• Ingrid Kenna, PTA

• Family Nurse Practitioner in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2009; 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.