Active NPI
Carla Dee Kelly, PHD
- Psychologist
- Tampa, FL
National Provider Identifier
1437291747
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PY0002141
- Practice address
- 4100 W Kennedy Blvd
#214
Tampa, FL 33609 - Phone
- (813) 289-6502
- Fax
- (813) 207-0022
- NPI assigned
- Feb 13, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | PY0002141 | FL | Primary |
Addresses
Primary practice location
4100 W Kennedy Blvd
#214
Tampa, FL 33609
Mailing address
209 S Coolidge Ave
Tampa, FL 33609
Phone (813) 286-0320
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00073171 | Other | BLUE CROSS BLUE SHIELD |
Other names 1
- Dr. Carla Kelly Dee
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY0002141 | FL | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1437291747",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "209 S COOLIDGE AVE",
"city": "TAMPA",
"state": "FL",
"postal_code": "33609",
"telephone_number": "813-286-0320",
"fax_number": "813-207-0022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4100 W KENNEDY BLVD",
"address_2": "#214",
"city": "TAMPA",
"state": "FL",
"postal_code": "33609",
"telephone_number": "813-289-6502",
"fax_number": "813-207-0022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "CARLA",
"middle_name": "DEE",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "FL",
"license": "PY0002141",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "00073171",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"first_name": "CARLA",
"last_name": "DEE",
"middle_name": "KELLY",
"prefix": "DR.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.