Jill Kelderman, PH.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

7965 Issued in FL

Practice address

500 Village Square Crossing
Suite 103
Palm Beach Gardens, FL 33410

Phone

(561) 688-9795

Fax

(561) 688-9796

NPI assigned

Aug 9, 2007

Last updated

Oct 4, 2011By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Center for Pediatric Neuropsychology, LLC

  • Clinical Neuropsychologist
  • Palm Beach Gardens, FL
  • NPI 1669700167
  NPD (past) Authorized official

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

{
    "created_epoch": "1186617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317686400000",
    "number": "1184815508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 VILLAGE SQUARE CROSSING",
            "address_2": "SUITE 103",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "33410",
            "telephone_number": "561-688-9795",
            "fax_number": "561-688-9796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 VILLAGE SQUARE CROSSING",
            "address_2": "SUITE 103",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "33410",
            "telephone_number": "561-688-9795",
            "fax_number": "561-688-9796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELDERMAN",
        "first_name": "JILL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-09",
        "last_updated": "2011-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "7965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "7965",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• KB Miracles LLC
• KC PBG Health Center, LLC (La Posada)
• Keith L Volstad Dcpa
• Elizabeth A Keith, PT, PCS
• Jodi Linn Keith, FNP
• Sylvia L Keller, PH. D., LMHC, CAP
• Taylor Marie Keller
• Devan R Kelley
• Catherine Amanda Kelly, NP
• Shannon Kathleen Kelly, PA-C

• Clinical Neuropsychologist in Palm Beach Gardens, FL
• Providers in Palm Beach Gardens, FL by specialty
• Clinical Neuropsychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; 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.