Individual provider Active NPI

Kelly Dyess, DO

  • Emergency Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1538276795
Registry record updated Mar 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OS9198 Issued in GA
Practice address
1 Shircliff Way
Jacksonville, FL 32886-3026
Phone
(904) 308-7300
Fax
(904) 346-0113
NPI assigned
Aug 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X OS9198 GA Primary

Addresses

Primary practice location

1 Shircliff Way
Jacksonville, FL 32886-3026

Mailing address

PO Box 100186
Gainesville, FL 32610-3026
Phone (352) 265-5911

Other identifiers 2

IdentifierTypeStateIssuer
276257900MedicaidFL
P00346860OtherFLRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20061213000430 FL Practitioner - Emergency Medicine 2961401294 Reassigns benefits to 2 organizations
I20200205002851 TN Practitioner - Emergency Medicine 2961401294 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Nova Southeastern College of Osteo Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1600 SW Archer
Gainesville, FL 32610-3003

1600 SW Archer Rd
Gainesville, FL 32610-3003

1600 SW Archer Rd RM
1191 Uf Health Surgical Specialists Shands
Gainesville, FL 32610-3003
Phone (352) 265-0535

2000 SW Archer Rd
Uf Health Congenital Heart Center Medical P
Gainesville, FL 32610-3003
Phone (352) 265-8250

2001 SW 13TH St
Gainesville, FL 32608-1532
Phone (352) 265-8990

Uf Health Test Site Pop Up 1600 SW Ar
Gainesville, FL 32610-3003
Phone (352) 392-1161

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
47.54 of 100Reported as apm
Quality
38.49
Promoting interoperability
0
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
3760TNMDOptometrist
OS9198GAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
App of Tennessee Ed, PLLC Emergency Medicine CurrentSince Nov 17, 2020 Accepting new patients
Paragon Emergency Services LLC Emergency Medicine CurrentSince Jan 1, 2016 Accepting new patients
Putnam Emergency Physicians, PLLC Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Mar 28, 2024 Accepting new patients
Emergency Coverage, LLC Emergency Medicine CurrentSince Jan 1, 2020 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Mar 28, 2024 Accepting new patients
Florida Em-I Medical Services, PA Emergency Medicine Past Accepting new patients
Cobblestone Emergency Physicians Emergency Medicine Past Accepting new patients
Baker Community Health Center Inc Emergency Medicine Past Accepting new patients

Locations

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

3625 University Blvd S
Jacksonville, FL 32216
Phone (904) 333-9404

11850 Atlantic Blvd
Jacksonville, FL 32225
Phone (904) 702-1330

2001 Kingsley Ave
Orange Park, FL 32073
Phone (904) 215-7015

1 Medical Center Blvd
Cookeville, TN 38501
Phone (931) 783-2334

421 S Main St
Crossville, TN 38555
Phone (931) 260-1465

1607 S Locust Ave
Lawrenceburg, TN 38464
Phone (731) 287-2244

907 Lamar Alexander Pkwy
Maryville, TN 37804
Phone (865) 766-8818

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: kdyess702314@direct.shands.ufl.edu

Organizations & group practices 9

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1538276795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100186",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326103026",
            "telephone_number": "352-265-5911",
            "fax_number": "352-265-5606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SHIRCLIFF WAY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "328863026",
            "telephone_number": "904-308-7300",
            "fax_number": "904-346-0113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYESS",
        "first_name": "KELLY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-24",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "OS9198",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "276257900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00346860",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.