Individual provider Active NPI

Kelly Kessler

  • Sports Medicine (Family Medicine) Physician
  • Melbourne, FL
National Provider Identifier
1891345542
Registry record updated Sep 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
AL4402 Issued in FL
Practice address
150 W University Blvd
Melbourne, FL 32901-6982
Phone
(321) 674-8000
NPI assigned
Sep 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X AL4402 FL Primary

Addresses

Primary practice location

150 W University Blvd
Melbourne, FL 32901-6982

Mailing address

150 W University Blvd
Melbourne, FL 32901-6982

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

State licenses

LicenseStateTypeSpecialty
AL4402FLMDSports Medicine (Family Medicine) Physician

NPI Registry JSON

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

{
    "created_epoch": "1568505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568505600000",
    "number": "1891345542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 W UNIVERSITY BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329016982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 W UNIVERSITY BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329016982",
            "telephone_number": "321-674-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KESSLER",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-15",
        "last_updated": "2019-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "FL",
            "license": "AL4402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2019; 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.