Individual provider Active NPI

Danielle Rose Kelley, DPT

  • Physical Therapist
  • Summerfield, FL
National Provider Identifier
1841534849
Registry record updated Mar 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT35625 Issued in FL
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

Updated by the provider on Mar 3, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
871577DCMDPhysical Therapist
PT35625FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.