Dr Jan Kelley PA

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH6944F Issued in FL

Legal business name

DR JAN KELLEY PA

Practice address

3400 Tamiami TRL
Suite 103
Port Charlotte, FL 33952-8102

Phone

(941) 625-2667

NPI assigned

Sep 24, 2012

Last updated

Sep 24, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jan Kelley, DC

Title

Owner

Phone

(941) 625-2667

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1348444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348444800000",
    "number": "1417208000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 TAMIAMI TRL",
            "address_2": "SUITE 103",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339528102",
            "telephone_number": "941-625-2667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 TAMIAMI TRL",
            "address_2": "SUITE 103",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339528102",
            "telephone_number": "941-625-2667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR JAN KELLEY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-24",
        "last_updated": "2012-09-24",
        "status": "A",
        "authorized_official_last_name": "KELLEY",
        "authorized_official_first_name": "JAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "941-625-2667",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH6944F",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Port Charlotte, FL
• Providers in Port Charlotte, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.