Bridget Kelly

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9107290 Issued in FL

Practice address

7009 Dr Phillips Blvd Ste 100
Orlando, FL 32819-5122

Phone

(407) 218-4550

NPI assigned

Aug 4, 2014

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

Physician Assistant

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

{
    "created_epoch": "1407110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407110400000",
    "number": "1225447345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5680 OAK LAKE TRL",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327657368",
            "telephone_number": "412-608-2380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7009 DR PHILLIPS BLVD STE 100",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328195122",
            "telephone_number": "407-218-4550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "BRIDGET",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-04",
        "last_updated": "2014-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9107290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica Kelly-Benjamin
• Eileen Mary Kelly-Gallagher, LMHC
• Amy K Kelly-Vega, ARNP
• Ann 'Anita' Kelly, MS, LMHC
• Ashley Bailes Kelly, FNP-BC
• Daeon Ahkee Kelly
• Dillon Michael Kelly, PA-C
• Gabriel Kelly
• Hopelyn Latifah Kelly
• John Joseph Kelly IV, MD

• Physician Assistant in Orlando, FL
• Providers in Orlando, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2014; 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.