Organization Active NPI

Hands on Performance LLC

  • Health Service Clinic/Center
  • Port St Lucie, FL
National Provider Identifier
1417205147
Registry record updated Aug 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
HANDS ON PERFORMANCE LLC
Practice address
1430 SW Saint Lucie West Blvd
Suite 103
Port St Lucie, FL 34986-2134
Phone
(772) 785-8500
NPI assigned
Aug 28, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2012

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

Authorized official

Name
Dr. Michael T Kelly, DC
Title
Owner
Phone
(772) 342-4612

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X Primary

Addresses

Primary practice location

1430 SW Saint Lucie West Blvd
Suite 103
Port St Lucie, FL 34986-2134

Mailing address

1430 SW Saint Lucie West Blvd
Suite 103
Port St Lucie, FL 34986-2134
Phone (772) 785-8500

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1346112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346284800000",
    "number": "1417205147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 SW SAINT LUCIE WEST BLVD",
            "address_2": "SUITE 103",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349862134",
            "telephone_number": "772-785-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 SW SAINT LUCIE WEST BLVD",
            "address_2": "SUITE 103",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349862134",
            "telephone_number": "772-785-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HANDS ON PERFORMANCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-28",
        "last_updated": "2012-08-30",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "772-342-4612",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2012; 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.