Kelly Cares Inc

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Legal business name

KELLY CARES INC

Practice address

1228 Kennedy Rd
Daytona Beach, FL 32117-4120

Phone

(386) 268-3318

NPI assigned

Jul 8, 2020

Organization subpart

No

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

Authorized official

Name

Shanice Kelly

Title

Owner

Phone

(386) 268-3318

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1594166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621209600000",
    "number": "1831717792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1228 KENNEDY RD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321174120",
            "telephone_number": "386-268-3318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1228 KENNEDY RD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321174120",
            "telephone_number": "386-268-3318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY CARES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-08",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-17",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "SHANICE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-268-3318"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "107308600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James H Kaye, DO
• Nelson Kazie, MD
• Peter Keirstead, L.M.H.C
• Kathy Keith
• Corrina Kelch, ARNP
• Coreen Kelly
• Daniel William Kelly, PA-C
• Elizabeth Victoria Kelly, PA STUDENT
• Shawn Demian Kelly, APRN
• Robert Kemp, LMHC

• Developmental Disabilities Clinic/Center in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Developmental Disabilities Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2021; 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.