Andrew Kelly

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-20-44790 Issued in FL

Practice address

2431 Creighton Rd
Pensacola, FL 32504

Phone

(850) 607-6910

Fax

(850) 607-6932

NPI assigned

Oct 9, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Trumpet Behavioral Helth

  • Behavior Technician
  • Fairborn, OH
  • NPI 1528556784
  NPD

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

{
    "created_epoch": "1539043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1417422171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3771 STEFANI RD",
            "city": "CANTONMENT",
            "state": "FL",
            "postal_code": "325337795",
            "telephone_number": "850-607-6910",
            "fax_number": "850-607-6932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2431 CREIGHTON RD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "32504",
            "telephone_number": "850-607-6910",
            "fax_number": "850-607-6932"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12505 Starkey Rd Ste J",
            "address_purpose": "LOCATION",
            "city": "Largo",
            "state": "FL",
            "postal_code": "337732617",
            "country_code": "US",
            "telephone_number": "727-280-6643",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "ANDREW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-09",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "FL",
            "license": "0-20-10774",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-20-44790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sherri Lynn Kelley
• Suzanne Kelley, RPH, CPH
• Tara Ruth Kelley
• Kelly Demuynck
• Kelly Stone Counseling LLC
• Beth Kelly
• David Kelly
• Jessica Lynn Kelly, D.C.
• Kristen L Kelly, PTA
• Laura Kelly

• Behavior Analyst in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2020; 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.