Active NPI
Danielle Rose Kelley, DPT
- Physical Therapist
- Summerfield, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT35625
- Practice address
- 17270 SE 109TH Terrace Rd
Summerfield, FL 34491-9015 - Phone
- (352) 336-6000
- NPI assigned
- Nov 15, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 871577 | DC | |
| Physical Therapist | 225100000X | PT27591 | FL | |
| Physical Therapist | 225100000X | PT35625 | FL | Primary |
Addresses
Primary practice location
17270 SE 109TH Terrace Rd
Summerfield, FL 34491-9015
Mailing address
21756 State Road 54
Ste 102
Lutz, FL 33549-2905
Phone (352) 336-6000
Other practice location 1
600 Pennsylvania Ave SE
Suite 202
Washington, DC 20003-4316
Phone (202) 543-9400
Other practice location 2
1015 18th St NW Ste 400
Washington, DC 20036-5209
Phone (202) 900-2245
Other practice location 3
1850 M St NW Ste 750
Washington, DC 20036-5818
Phone (202) 835-2222
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 871577 | DC | MD | Physical Therapist |
| PT35625 | FL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Innovative Therapies Group Inc | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Occupational Therapist
- Lady Lake, FL
- NPI 1174768360
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1352937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646265600000",
"number": "1841534849",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21756 STATE ROAD 54",
"address_2": "STE 102",
"city": "LUTZ",
"state": "FL",
"postal_code": "335492905",
"telephone_number": "352-336-6000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17270 SE 109TH TERRACE RD",
"city": "SUMMERFIELD",
"state": "FL",
"postal_code": "344919015",
"telephone_number": "352-336-6000"
}
],
"practiceLocations": [
{
"address_1": "600 Pennsylvania Ave SE",
"address_2": "Suite 202",
"address_purpose": "LOCATION",
"city": "Washington",
"state": "DC",
"postal_code": "200034316",
"country_code": "US",
"telephone_number": "202-543-9400",
"fax_number": "202-543-8990",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1015 18th St NW Ste 400",
"address_purpose": "LOCATION",
"city": "Washington",
"state": "DC",
"postal_code": "200365209",
"country_code": "US",
"telephone_number": "202-900-2245",
"fax_number": "202-900-2249",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1850 M St NW Ste 750",
"address_purpose": "LOCATION",
"city": "Washington",
"state": "DC",
"postal_code": "200365818",
"country_code": "US",
"telephone_number": "202-835-2222",
"fax_number": "202-969-1798",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KELLEY",
"first_name": "DANIELLE",
"middle_name": "ROSE",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-11-15",
"last_updated": "2022-03-03",
"certification_date": "2022-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "DC",
"license": "871577",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT27591",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT35625",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Summerfield, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.