Jessica Lynn Kelly, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH12693 Issued in FL

Practice address

2122 W Nine Mile Rd
Pensacola, FL 32534-9464

Phone

(850) 473-5555

Fax

(850) 473-5505

NPI assigned

Jan 5, 2019

Last updated

Mar 11, 2021By the provider in NPPES

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

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Healthsource of Northwest Florida LLCGroup PAC ID 0143387779, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Healthsource of Northwest Florida LLC

  dba Healthsource of NW Florida

  • Chiropractor
  • Pensacola, FL
  • NPI 1104015866
  Medicare reassignment Care Compare group NPD
• Healthsource of Milton LLC

  • Chiropractor
  • Milton, FL
  • NPI 1285321109
  NPD
• NW Health Services LLC

  • Chiropractor
  • Pensacola, FL
  • NPI 1740045574
  NPD

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

{
    "created_epoch": "1546646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1730652496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4650 WOODBINE RD",
            "city": "PACE",
            "state": "FL",
            "postal_code": "325718717",
            "telephone_number": "850-473-5555",
            "fax_number": "850-473-5505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2122 W NINE MILE RD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325349464",
            "telephone_number": "850-473-5555",
            "fax_number": "850-473-5505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-05",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH12693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Demuynck
• Kelly Stone Counseling LLC
• Andrew Kelly
• Beth Kelly
• David Kelly
• Kristen L Kelly, PTA
• Laura Kelly
• Rebeca J Kelly, PT
• Ryan Kelly, RN
• Susan Gail Kelly, LMT

• Chiropractor in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.