Carol Ann Kelly Dilworth, L.B.S.W

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

License

25770 Issued in TX

Practice address

7555 Foss MDWS
San Antonio, TX 78244-2250

Phone

(210) 875-4663

Fax

(000) 000-0000

NPI assigned

Jul 18, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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": "1184716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196899200000",
    "number": "1720288806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7555 FOSS MDWS",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782442250",
            "telephone_number": "210-875-4663",
            "fax_number": "000-000-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7555 FOSS MDWS",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782442250",
            "telephone_number": "210-875-4663",
            "fax_number": "000-000-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY DILWORTH",
        "first_name": "CAROL",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "L.B.S.W",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-18",
        "last_updated": "2007-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TX",
            "license": "25770",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "TX",
            "license": "25770",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS STATE BOARD OF SOCI",
            "identifier": "25770",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Renee Kellum, RBT
• Daniel H Kellum Sr., DO
• Denise Kellum, PA-C
• John Hansford Kellum, M.D.
• Dalisa Kelly Bacon
• Kelly J Smith MD PA (Children's Asthma, Sleep & Pulmonary Institute)
• Kelly J Smith MD PA
• Sophronia Dee Kelly-Zion, LCSW
• Aldon Kelly Jr.
• Alicia Kelly, SLP

• Case Manager/Care Coordinator in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Case Manager/Care Coordinator in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2007; 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.