Deveeta R Kelly

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

401697611014 Issued in OH

Practice address

724 E Laclede Ave
Youngstown, OH 44502-2344

Phone

(330) 314-2538

NPI assigned

Jul 6, 2020

Last updated

Jul 6, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1593993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593993600000",
    "number": "1669090726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "724 E LACLEDE AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445022344",
            "telephone_number": "330-314-2538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "724 E LACLEDE AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445022344",
            "telephone_number": "330-314-2538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "DEVEETA",
        "middle_name": "R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-06",
        "last_updated": "2020-07-06",
        "certification_date": "2020-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "OH",
            "license": "401697611014",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "401697611014",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Rebecca Kegelmyer
• Brianna Keith
• Debra Lynn Kellam, HOME HEALTH AID
• Tracy Kellam
• Cortnee Janae Kelly, ACNP
• Lorraine Kelly, MS, LPCC-S
• Louis Kelly
• Sharon Kelly
• Terence Patrick Kelly, D.D.S.
• Jessica Leigh Keltenbaugh

• Home Health Agency in Youngstown, OH
• Providers in Youngstown, OH by specialty
• Home Health Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.