NPIMap

Organization Active NPI

Kindred Development 17, LLC

Doing business as Kindred Hospital Melbourne

  • Long Term Care Hospital
  • Melbourne, FL
National Provider Identifier
1497983936
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care HospitalTaxonomy code 282E00000X
License
4501 Issued in FL
Legal business name
KINDRED DEVELOPMENT 17, LLC
Doing business as
Kindred Hospital Melbourne
Practice address
765 W Nasa Blvd
Melbourne, FL 32901-1815
Phone
(321) 733-5725
Fax
(321) 733-5725
NPI assigned
Jun 23, 2009
Last updated
Oct 29, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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

Authorized official

Name
Johnetta Traylor
Title
Authorized Official
Phone
(502) 596-6063

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Hospital 282E00000X 4501 FL Primary

Addresses

Primary practice location

765 W Nasa Blvd
Melbourne, FL 32901-1815

Mailing address

765 W Nasa Blvd
Melbourne, FL 32901-1815
Phone (321) 733-5725

Other names 1

  • Kindred Hospital Melbourne Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091005000450 FL Part A Provider - Hospital 0547306516 Practice locations: Melbourne, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1497983936. Details of each certification follow.

Hospital certification: CCN 102027

Legal name
KINDRED DEVELOPMENT 17, LLC
Doing business as
KINDRED HOSPITAL MELBOURNE
Certification status
Active
Provider type (POS)
Hospital – Long-term
Participating since
Aug 1, 2010
Last certification
Dec 13, 2018
Beds
60
Ownership / control type
Private (for profit)
Organization structure
LLCProprietary
Enrollment address
765 W Nasa Blvd
Melbourne, FL 32901-1815
Main/Primary Hospital Location
Hospital subgroups
General, Acute care, Long-term

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Long-term care hospital

Medicare Care Compare
Listed as
Kindred Hospital MelbourneCCN 102027 · All quality measures
Ownership
For profit
Certified
Aug 1, 2010
Medicare certification status
ActiveFrom the Provider of Services file
Beds
60

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 15

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kindred Healthcare Operating LLC Organization, Louisville, KY LLC, For-profit 5% Or Greater Indirect Ownership Interest Feb 26, 1998 100%
Kindred Development 17, LLC Organization, Louisville, KY LLC 5% Or Greater Direct Ownership Interest Mar 17, 2025 100%
Kentucky Hospital Intermediate LLC Organization, Louisville, KY LLC, For-profit 5% Or Greater Indirect Ownership Interest Jul 2, 2018 100%
Kindred Hospitals East LLC Organization, Louisville, KY LLC, For-profit 5% Or Greater Direct Ownership Interest Mar 12, 1998 100%
Kindred Healthcare LLC Organization, Louisville, KY LLC, For-profit 5% Or Greater Indirect Ownership Interest Mar 27, 1998 100%
Scott Graeser Individual Corporate OfficerVice President, Treasurer Aug 19, 2022
Dana M Rock Individual Corporate OfficerAssistant Administrator Dec 9, 2024
Johnetta M Traylor Individual Corporate OfficerAdministrator Dec 9, 2024
W-2 Managing EmployeeAd; Dec 9, 2024
Kentucky Hospital Holdings LLC Organization, Louisville, KY LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Jul 2, 2018 100%
Mark Laroche Individual Corporate OfficerPresident Mar 17, 2025
Deanna Schiavone Individual Corporate OfficerChief Financial Officer Aug 22, 2022
Knight Health Holdings LLC Organization, Louisville, KY LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Dec 23, 2021 100%
Michael Joseph Bean Individual Corporate OfficerVice President, Tax Jun 16, 2015
Knight Health LLC Organization, Louisville, KY LLC, For-profit 5% Or Greater Indirect Ownership Interest Dec 23, 2021 100%
Kentucky Hospital Holdings JV LP Organization, Louisville, KY Holding company, For-profit 5% Or Greater Indirect Ownership Interest Jul 2, 2018 100%

Owners & managing parties with NPI records 17

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 17

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Kindred Hospital MelbourneMelbourne, FL, CCN 10TA27 Hospital 5% Or Greater Direct Ownership Interest (100%) Mar 17, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 97

Facilities that share an organizational owner with 5% or greater ownership or operational control.

  • Kindred Development 17, LLC

    dba Kindred Hospital Melbourne (Acute Rehab Unit)

    • Rehabilitation Hospital Unit
    • Melbourne, FL
    • NPI 1841886959

    Kentucky Hospital Holdings JV LP, Kentucky Hospital Holdings LLC, Kentucky Hospital Intermediate LLC, Kindred Development 17, LLC, Kindred Healthcare LLC, Kindred Healthcare Operating LLC, Kindred Hospitals East LLC, Knight Health Holdings LLC, KN

    CMS ownership
  • Kindred Hospital Palm Beach LLC

    dba Kindred Hospital The Palm Beaches

    • Long Term Care Hospital
    • Riviera Beach, FL
    • NPI 1295905255

    Kentucky Hospital Holdings JV LP, Kentucky Hospital Holdings LLC, Kentucky Hospital Intermediate LLC, Kindred Healthcare LLC, Kindred Healthcare Operating LLC, Kindred Hospitals East LLC, Knight Health Holdings LLC, Knight Health LLC

    CMS ownership
  • Kindred Hospital Palm Beach LLC

    dba Kindred Hospital The Palm Beaches (Acute Rehab Unit)

    • Rehabilitation Hospital Unit
    • Riviera Beach, FL
    • NPI 1609572312

    Kentucky Hospital Holdings JV LP, Kentucky Hospital Holdings LLC, Kentucky Hospital Intermediate LLC, Kindred Healthcare LLC, Kindred Healthcare Operating LLC, Kindred Hospitals East LLC, Knight Health Holdings LLC, Knight Health LLC

    CMS ownership
  • Kindred Hospitals East, LLC

    dba Kindred Hospital - Ocala

    • Long Term Care Hospital
    • Ocala, FL
    • NPI 1063441269

    Kentucky Hospital Holdings JV LP, Kentucky Hospital Holdings LLC, Kentucky Hospital Intermediate LLC, Kindred Healthcare LLC, Kindred Healthcare Operating LLC, Knight Health Holdings LLC, Knight Health LLC

    CMS ownership
  • Kindred Hospitals East, LLC

    dba Kindred Hospital - North Florida (Acute Rehab Unit)

    • Rehabilitation Hospital Unit
    • Green Cove Springs, FL
    • NPI 1124651351

    Kentucky Hospital Holdings JV LP, Kentucky Hospital Holdings LLC, Kentucky Hospital Intermediate LLC, Kindred Healthcare LLC, Kindred Healthcare Operating LLC, Knight Health Holdings LLC, Knight Health LLC

    CMS ownership
  • Kindred Hospitals East, LLC

    dba Kindred Hospital - North Florida

    • Long Term Care Hospital
    • Green Cove Springs, FL
    • NPI 1134204720

    Kentucky Hospital Holdings JV LP, Kentucky Hospital Holdings LLC, Kentucky Hospital Intermediate LLC, Kindred Healthcare LLC, Kindred Healthcare Operating LLC, Knight Health Holdings LLC, Knight Health LLC

    CMS ownership
  • Kindred Hospitals East, LLC

    dba Kindred Hospital - South Florida Ft. Lauderdale (Acute Rehab Unit)

    • Rehabilitation Hospital Unit
    • Fort Lauderdale, FL
    • NPI 1376176503

    Kentucky Hospital Holdings JV LP, Kentucky Hospital Holdings LLC, Kentucky Hospital Intermediate LLC, Kindred Healthcare LLC, Kindred Healthcare Operating LLC, Knight Health Holdings LLC, Knight Health LLC

    CMS ownership
  • Kindred Hospitals East, LLC

    dba Kindred Hospital - Bay Area - Tampa

    • Long Term Care Hospital
    • Tampa, FL
    • NPI 1710062393

    Kentucky Hospital Holdings JV LP, Kentucky Hospital Holdings LLC, Kentucky Hospital Intermediate LLC, Kindred Healthcare LLC, Kindred Healthcare Operating LLC, Knight Health Holdings LLC, Knight Health LLC

    CMS ownership
  • Kindred Hospitals East, LLC

    dba Kindred Hospital - Bay Area - St. Petersburg (Acute Rehab Unit)

    • Rehabilitation Hospital Unit
    • St Petersburg, FL
    • NPI 1801429030

    Kentucky Hospital Holdings JV LP, Kentucky Hospital Holdings LLC, Kentucky Hospital Intermediate LLC, Kindred Healthcare LLC, Kindred Healthcare Operating LLC, Knight Health Holdings LLC, Knight Health LLC

    CMS ownership
  • Kindred Hospitals East, LLC

    dba Kindred Hospital - South Florida Ft. Lauderdale

    • Long Term Care Hospital
    • Fort Lauderdale, FL
    • NPI 1861577306

    Kentucky Hospital Holdings JV LP, Kentucky Hospital Holdings LLC, Kentucky Hospital Intermediate LLC, Kindred Healthcare LLC, Kindred Healthcare Operating LLC, Knight Health Holdings LLC, Knight Health LLC

    CMS ownership
  • Transitional Hospitals of Tampa LLC

    dba Kindred Hospital - Central Tampa

    • Long Term Care Hospital
    • Tampa, FL
    • NPI 1164507752

    Kentucky Hospital Holdings JV LP, Kentucky Hospital Holdings LLC, Kentucky Hospital Intermediate LLC, Kindred Healthcare LLC, Kindred Healthcare Operating LLC, Knight Health Holdings LLC, Knight Health LLC

    CMS ownership
  • Andalusia Physician Practices LLC

    dba Andalusia Family Healthcare

    • Rural Health Clinic/Center
    • Andalusia, AL
    • NPI 1417663576

    Knight Health Holdings LLC

    CMS ownership
View all 97

Practitioners & affiliated clinicians

Affiliated clinicians 16

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1245715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761696000000",
    "number": "1497983936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "765 W NASA BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329011815",
            "telephone_number": "321-733-5725",
            "fax_number": "321-733-5799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 W NASA BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329011815",
            "telephone_number": "321-733-5725",
            "fax_number": "321-733-5725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINDRED DEVELOPMENT 17, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-23",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A",
        "authorized_official_last_name": "TRAYLOR",
        "authorized_official_first_name": "JOHNETTA",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "502-596-6063"
    },
    "taxonomies": [
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": "FL",
            "license": "4501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kindred Hospital Melbourne",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kindred Hospital Melbourne",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.