Active NPI
Scott T. Kelley, MD
- Surgery Physician
- Lakeland, FL
National Provider Identifier
1811938996
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- ME87127
- Practice address
- 1600 Lakeland Hills Blvd
Lakeland, FL 33805-3019 - Phone
- (863) 680-7486
- Fax
- (866) 264-8519
- NPI assigned
- Jun 9, 2006
- Last updated
- Nov 27, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Oncology Physician | 2086X0206X | ME87127 | FL | |
| Surgery Physician | 208600000X | ME87127 | FL | Primary |
Addresses
Primary practice location
1600 Lakeland Hills Blvd
Lakeland, FL 33805-3019
Mailing address
1600 Lakeland Hills Blvd
Lakeland, FL 33805-3019
Phone (863) 680-7000
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | skelley6700@direct.watsonclinicad.com | Watson Clinic LLP |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME87127 | FL | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nantucket Cottage Hospital | Current | Accepting new patients | |
| Nantucket Cottage Hospital | Current | Accepting new patients | |
| Nantucket Physicians Organization | Current | Accepting new patients | |
| University Medical Service Association Inc | Past | Accepting new patients | |
| Watson Clinic LLP | Past | Accepting new patients |
Locations
57 Prospect St
Nantucket, MA 02554
Phone (508) 228-1200
Interoperability endpoints
- skelley6700@direct.watsonclinicad.com
Organizations & group practices 5
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.
-
- Rural Acute Care Hospital
- Nantucket, MA
- NPI 1447214622
-
- Orthopaedic Surgery Physician
- Nantucket, MA
- NPI 1568798510
-
dba Nantucket Cottage Medical Group
- Rural Health Clinic/Center
- Nantucket, MA
- NPI 1477021608
-
- Durable Medical Equipment & Medical Supplies
- Tampa, FL
- NPI 1194276576
-
- Clinical Medical Laboratory
- Lakeland, FL
- NPI 1558409730
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701043200000",
"number": "1811938996",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1600 LAKELAND HILLS BLVD",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338053019",
"telephone_number": "863-680-7000",
"fax_number": "866-264-8519"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 LAKELAND HILLS BLVD",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338053019",
"telephone_number": "863-680-7486",
"fax_number": "866-264-8519"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLEY",
"first_name": "SCOTT",
"middle_name": "T.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-09",
"last_updated": "2023-11-27",
"certification_date": "2020-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "2086X0206X",
"taxonomy_group": "",
"desc": "Surgery, Surgical Oncology",
"state": "FL",
"license": "ME87127",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "FL",
"license": "ME87127",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "skelley6700@direct.watsonclinicad.com",
"affiliation": "Y",
"endpointDescription": "Direct Message Address",
"affiliationName": "Watson Clinic LLP",
"address_1": "1430 Lakeland Hills Blvd",
"city": "Lakeland",
"state": "FL",
"country_code": "US",
"postal_code": "338053202",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Lakeland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.