Individual provider Active NPI

Lori E Kelvy, NURSE PRACTITIONER

  • Nurse Practitioner
  • Hollywood, FL
National Provider Identifier
1700519915
Registry record updated Jul 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11020605 Issued in FL
Practice address
2950 Solano Ave
Hollywood, FL 33024-3785
Phone
(305) 849-9411
NPI assigned
Jul 5, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11020605 FL Primary

Addresses

Primary practice location

2950 Solano Ave
Hollywood, FL 33024-3785

Mailing address

2950 Solano Ave Apt 105
Hollywood, FL 33024-3786
Phone (305) 849-9411

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
I20230425000464 FL Practitioner - Nurse Practitioner 8729443825 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Group practices
The Clinicians, LLCGroup PAC ID 7214154509, 51 clinicians

Practice addresses (Care Compare)

10970 Cross Creek Blvd
Suite D
Tampa, FL 33647-4056
Phone (813) 369-5969

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11020605FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Unique Management Group PastSince Jun 6, 2024 Accepting new patients
Tampa Family Health Centers Inc Past Accepting new patients

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1656979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1700519915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2950 SOLANO AVE APT 105",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330243786",
            "telephone_number": "305-849-9411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 SOLANO AVE",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330243785",
            "telephone_number": "305-849-9411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELVY",
        "first_name": "LORI",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-05",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11020605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.