Individual provider Active NPI

Devin Walter Kelly, PA-C

  • Physician Assistant
  • Jacksonville, FL
National Provider Identifier
1871117689
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9113409 Issued in FL
Practice address
14540 Old Saint Augustine Rd Ste 2207
Jacksonville, FL 32258-7419
Phone
(904) 388-6518
Fax
(904) 393-7887
NPI assigned
Jun 8, 2020
Last updated
Jun 17, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9113409 FL Primary

Addresses

Primary practice location

14540 Old Saint Augustine Rd Ste 2207
Jacksonville, FL 32258-7419

Mailing address

PO Box 746647
Atlanta, GA 30374-6647
Phone (904) 202-2092

Other practice location 1

1747 Baptist Clay Dr Ste 200
Fleming Island, FL 32003-8505
Phone (904) 202-6683

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200818004154 FL Practitioner - Physician Assistant 5597181776 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lyerly Baptist IncGroup PAC ID 9830112226, 72 clinicians

Practice addresses (Care Compare)

1370 13TH Ave S
Jacksonville, FL 32250-3206
Phone (904) 388-6518

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
59.59 of 100Reported as apm
Quality
59.93
Promoting interoperability
0
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9113409FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians Inc CurrentSince Aug 17, 2020 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Aug 17, 2020 Accepting new patients
Lyerly Baptist Inc Physician Assistant CurrentSince Nov 1, 2025 Accepting new patients
Integrity Spine and Orthopedics LLC PastSince Mar 3, 2024 Accepting new patients

Locations

14540 Old St Augustine Rd
Ste 2207
Jacksonville, FL 32258
Phone (904) 224-8090

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

800 Prudential Dr
Jacksonville, FL 32207
Phone (904) 202-2000

1370 13th Ave S
Ste 215
Jax Bch, FL 32250
Phone (904) 249-1041

Interoperability endpoints

  • Direct secure messaging: dkelly334116@baptisthealthsystemjacksonville.direct-ci.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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1591574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1871117689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746647",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746647",
            "telephone_number": "904-202-2092",
            "fax_number": "904-376-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14540 OLD SAINT AUGUSTINE RD STE 2207",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322587419",
            "telephone_number": "904-388-6518",
            "fax_number": "904-393-7887"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1747 Baptist Clay Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Fleming Island",
            "state": "FL",
            "postal_code": "320038505",
            "country_code": "US",
            "telephone_number": "904-202-6683",
            "fax_number": "904-376-3062",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "DEVIN",
        "middle_name": "WALTER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-08",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9113409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.