Jacqueline F Kelly, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME42703 Issued in FL

Practice address

1750 17TH St
Sarasota, FL 34234-8632

Phone

(941) 529-0200

NPI assigned

Mar 24, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: jacqueline.kelly.1@16972.direct.athenahealth.com

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1669432498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 17TH ST STE E",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342348666",
            "telephone_number": "941-529-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 17TH ST",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342348632",
            "telephone_number": "941-529-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JACQUELINE",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-24",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME42703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Elizabeth Kellogg, D.C.
• Kelly Ann Dowiak PLLC
• Debra Kelly, OT
• Eileen Joyce Kelly, LMT
• Hunter Kelly, CF-SLP
• Melia Kelly, LCSW
• Pamela Marie Kelly, ARNP
• Thomas F Kelly Jr., M.D., P.A.
• Tammy Kelz, MA34584
• Diane Margaret Kemper, CRNP

• Pediatrics Physician in Sarasota, FL
• Providers in Sarasota, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.