Individual provider Active NPI

Kelli Elder Cutright, LCSW

  • Clinical Social Worker
  • Ponte Vedra Beach, FL
National Provider Identifier
1386009918
Registry record updated Mar 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW13244 Issued in FL
Practice address
100 Executive Way Ste 206
Ponte Vedra Beach, FL 32082-2714
Phone
(904) 325-4370
NPI assigned
Dec 26, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW13244 FL Primary

Addresses

Primary practice location

100 Executive Way Ste 206
Ponte Vedra Beach, FL 32082-2714

Mailing address

1221 1St St S Apt 5C
Jacksonville Beach, FL 32250-6444
Phone (904) 325-4370

Other practice location 1

315 10th Ave S
Jacksonville Beach, FL 32250-5135
Phone (904) 325-4370

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160830000557 FL Practitioner - Clinical Social Worker 3072808013 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

100 Executive Way
Suite 206
Ponte Vedra, FL 32082-2714
Phone (904) 325-4370

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kelli Elder Cutright, LLC CurrentSince Jul 8, 2016 Accepting new patients

Locations

100 Executive Way
Ste 206
Ponte Vedra Beach, FL 32082
Phone (904) 273-4094

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1451088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678924800000",
    "number": "1386009918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 1ST ST S APT 5C",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322506444",
            "telephone_number": "904-325-4370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 EXECUTIVE WAY STE 206",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320822714",
            "telephone_number": "904-325-4370"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 10th Ave S",
            "address_purpose": "LOCATION",
            "city": "Jacksonville Beach",
            "state": "FL",
            "postal_code": "322505135",
            "country_code": "US",
            "telephone_number": "904-325-4370",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUTRIGHT",
        "first_name": "KELLI",
        "middle_name": "ELDER",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-26",
        "last_updated": "2023-03-16",
        "certification_date": "2021-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW13244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponte Vedra Beach, FL

Sources for this page

Verify at the official NPI Registry.