Individual provider Active NPI

Anita F Kelley-Dukes, D.C.

  • Chiropractor
  • Crestview, FL
National Provider Identifier
1245268192
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH0003713 Issued in FL
Practice address
1078 S Ferdon Blvd
Suite a
Crestview, FL 32536-4510
Phone
(850) 682-0381
Fax
(850) 683-0981
NPI assigned
Jun 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH0003713 FL Primary

Addresses

Primary practice location

1078 S Ferdon Blvd
Suite a
Crestview, FL 32536-4510

Mailing address

1078 S Ferdon Blvd
Suite a
Crestview, FL 32536-4510
Phone (850) 682-0381

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH0003713FLMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245268192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1078 S FERDON BLVD",
            "address_2": "SUITE A",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325364510",
            "telephone_number": "850-682-0381",
            "fax_number": "850-683-0981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1078 S FERDON BLVD",
            "address_2": "SUITE A",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325364510",
            "telephone_number": "850-682-0381",
            "fax_number": "850-683-0981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY-DUKES",
        "first_name": "ANITA",
        "middle_name": "F",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH0003713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crestview, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.