Individual provider Active NPI

Norah J.M. Kelley, APRN

  • Adult Health Nurse Practitioner
  • Hollywood, FL
National Provider Identifier
1437867595
Registry record updated Apr 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APRN11021137 Issued in FL
Practice address
200 S Park Rd Ste 200
Hollywood, FL 33021-8541
Phone
(866) 986-2263
NPI assigned
Nov 8, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X APRN11021137 FL Primary

Addresses

Primary practice location

200 S Park Rd Ste 200
Hollywood, FL 33021-8541

Mailing address

41 Fallen Oak LN
Palm Coast, FL 32137-9132
Phone (386) 290-2866

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230418000372 FL Practitioner - Nurse Practitioner 8325413719 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

41 Fallen Oak LN
Palm Coast, FL 32137-9132

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11021137FLMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wound Technology Network Inc CurrentSince Apr 3, 2023 Accepting new patients
WT Health of Florida LLC CurrentSince Nov 17, 2025 Accepting new patients
Ideal Image PastSince Nov 1, 2022 Accepting new patients

Locations

200 S Park Rd
Ste 200
Hollywood, FL 33021
Phone (866) 986-2263

5979 Vineland Rd
Ste 109
Orlando, FL 32819
Phone (407) 270-7702

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1667865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1437867595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 FALLEN OAK LN",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321379132",
            "telephone_number": "386-290-2866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S PARK RD STE 200",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330218541",
            "telephone_number": "866-986-2263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "NORAH",
        "middle_name": "J.M.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-08",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN11021137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.