Individual provider Active NPI

Kelley E Sherwood, ARNP

  • Adult Health Nurse Practitioner
  • Winter Garden, FL
National Provider Identifier
1649606500
Registry record updated Aug 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
ARNP9186304 Issued in FL
Practice address
213 S Dillard St
Suite 240
Winter Garden, FL 34787-3522
Phone
(407) 614-1644
Fax
(407) 614-1635
NPI assigned
Sep 23, 2013
Last updated
Aug 12, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2014

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 ARNP9186304 FL Primary

Addresses

Primary practice location

213 S Dillard St
Suite 240
Winter Garden, FL 34787-3522

Mailing address

213 S Dillard St
Suite 240
Winter Garden, FL 34787-3522
Phone (407) 614-1644

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
I20131023001229 FL Practitioner - Nurse Practitioner 5496980765 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mid Florida Endocrine CurrentSince Oct 1, 2013 Accepting new patients
My Endocrinologist PA PastSince Feb 1, 2011 Accepting new patients

Locations

213 S Dillard St
Ste 130
Winter Garden, FL 34787
Phone (407) 614-1644

213 S Dillard St
Ste 240
Winter Garden, FL 34787
Phone (407) 409-8067

Organizations & group practices 2

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": "1379894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407801600000",
    "number": "1649606500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 S DILLARD ST",
            "address_2": "SUITE 240",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347873522",
            "telephone_number": "407-614-1644",
            "fax_number": "407-614-1635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 S DILLARD ST",
            "address_2": "SUITE 240",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347873522",
            "telephone_number": "407-614-1644",
            "fax_number": "407-614-1635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERWOOD",
        "first_name": "KELLEY",
        "middle_name": "E",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-23",
        "last_updated": "2014-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP9186304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Garden, FL

Sources for this page

Verify at the official NPI Registry.