Individual provider Active NPI

Kelly Marie Flesh

  • Family Nurse Practitioner
  • Coconut Creek, FL
National Provider Identifier
1144834151
Registry record updated May 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11018516 Issued in FL
Practice address
5375 NW 54TH St
Coconut Creek, FL 33073-3739
Phone
(407) 756-6853
NPI assigned
Sep 7, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2026

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

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X C-APN.0106015-C-NP CO
Family Nurse Practitioner 363LF0000X 71018172A IN
Nurse Practitioner 363L00000X C-RXN.0103873-C-NP CO
Family Nurse Practitioner 363LF0000X 11018516 FL Primary
Registered Nurse 163W00000X 9465064 FL
Family Nurse Practitioner 363LF0000X 908448 MS
Registered Nurse 163W00000X 95452181 CA
Nurse Practitioner 363L00000X 4052520 KY
Nurse Practitioner 363L00000X CNP261079 ME
Nurse Practitioner 363L00000X 1228122 TX
Nurse Practitioner 363L00000X 53-85277-112 KS

Addresses

Primary practice location

5375 NW 54TH St
Coconut Creek, FL 33073-3739

Mailing address

5375 NW 54TH St
Coconut Creek, FL 33073-3739
Phone (407) 756-6853

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, ME, FL, TX, KY5 enrollments
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 5

Enrollment IDStateProvider typePAC IDDetails
I20260522002622 KS Practitioner - Nurse Practitioner 4486124112 Reassigns benefits to 1 organization
I20260601001139 ME Practitioner - Nurse Practitioner 4486124112 Reassigns benefits to 2 organizations
I20260601001556 FL Practitioner - Nurse Practitioner 4486124112 Reassigns benefits to 3 organizations
I20260602000620 TX Practitioner - Nurse Practitioner 4486124112 Reassigns benefits to 2 organizations
I20260604001259 KY Practitioner - Nurse Practitioner 4486124112 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Daniel Funsch Jr MD PCGroup PAC ID 1951801836, 139 clinicians

Practice addresses (Care Compare)

1507 S Tuttle Ave
Sarasota, FL 34239-2608
Phone (212) 734-6621

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95452181CAMDRegistered Nurse
9465064FLMDRegistered Nurse
C-APN.0106015-C-NPCOMDNurse Practitioner
C-RXN.0103873-C-NPCOMDNurse Practitioner
53-85277-112KSMDNurse Practitioner
4052520KYMDNurse Practitioner
CNP261079MEMDNurse Practitioner
1228122TXMDNurse Practitioner
11018516FLMDFamily Nurse Practitioner
71018172AINMDFamily Nurse Practitioner
908448MSMDFamily Nurse Practitioner

Organizations & group practices 3

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": "1599436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779926400000",
    "number": "1144834151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5375 NW 54TH ST",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330733739",
            "telephone_number": "407-756-6853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5375 NW 54TH ST",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330733739",
            "telephone_number": "407-756-6853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLESH",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-07",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "C-APN.0106015-C-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71018172A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "C-RXN.0103873-C-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11018516",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9465064",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "908448",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95452181",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "4052520",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ME",
            "license": "CNP261079",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1228122",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KS",
            "license": "53-85277-112",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coconut Creek, FL

Sources for this page

Verify at the official NPI Registry.