Active NPI
Kelly Carson, PTA
- Contractor
- Saint Petersburg, FL
National Provider Identifier
1376835520
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- 1988
- Practice address
- 4100 14TH St NE
Saint Petersburg, FL 33703-5328 - Phone
- (727) 455-8305
- NPI assigned
- May 6, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 1988 | FL | Primary |
Addresses
Primary practice location
4100 14TH St NE
Saint Petersburg, FL 33703-5328
Mailing address
35746 Harper Ave
Clinton TWP, MI 48035-3212
Phone (813) 455-9621
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1988 | FL | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1304640000000",
"number": "1376835520",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35746 HARPER AVE",
"city": "CLINTON TWP",
"state": "MI",
"postal_code": "480353212",
"telephone_number": "813-455-9621"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4100 14TH ST NE",
"city": "SAINT PETERSBURG",
"state": "FL",
"postal_code": "337035328",
"telephone_number": "727-455-8305"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARSON",
"first_name": "KELLY",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-05-06",
"last_updated": "2011-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "FL",
"license": "1988",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Petersburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 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.