Kelly Tolle, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH10438 Issued in FL

Practice address

1130 Townpark Ave
Suite 1116
Lake Mary, FL 32746-4787

Phone

(407) 756-6998

NPI assigned

Oct 13, 2011

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1318464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318464000000",
    "number": "1699050369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 CHERRY LAKE WAY",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327461962",
            "telephone_number": "407-756-6998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 TOWNPARK AVE",
            "address_2": "SUITE 1116",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327464787",
            "telephone_number": "407-756-6998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLLE",
        "first_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-13",
        "last_updated": "2011-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH10438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Lake Mary, FL
• Providers in Lake Mary, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2011; 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.