Tara Kelly, A.R.N.P.

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

2170262 Issued in FL

Practice address

3220 S Douglas Rd Ste B
Miramar, FL 33025-2734

Phone

(954) 436-8444

Fax

(954) 436-1159

NPI assigned

Jan 29, 2007

Sex

Female

Sole proprietor

No

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)

Not enrolled

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.

• Liberty Medical Associates, P.a.

  • Primary Care Clinic/Center
  • Miami, FL
  • NPI 1265594626
  NPD (past)
• Pediatrics PA

  • Primary Care Clinic/Center
  • Miramar, FL
  • NPI 1053472019
  NPD (past)

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376689547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16264 SENECA CIR",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333312112",
            "telephone_number": "954-252-9330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3220 S DOUGLAS RD STE B",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330252734",
            "telephone_number": "954-436-8444",
            "fax_number": "954-436-1159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "TARA",
        "credential": "A.R.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "2170262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heba Ali Kazmi, OD
• KBS Medical PA
• KBS Medical PA
• Kulravee P Keegan, D.O.
• Araly Alexis Kelly, FNP
• Tracy Ann Kelly, PA
• Sabrina Kemp
• Kenneth O. Karp, MD, PA
• Key Solutions Network LLC
• Ammar A Khalil, LPTA

• Pediatric Nurse Practitioner in Miramar, FL
• Providers in Miramar, FL by specialty
• Pediatric Nurse Practitioner in Florida

• 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.