Individual provider Active NPI

Carolyn Kelly, ARNP

  • Critical Care Neonatal Nurse Practitioner
  • St Petersburg, FL
National Provider Identifier
1912174913
Registry record updated May 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Neonatal Nurse PractitionerTaxonomy code 363LN0005X
License
ARNP3003172 Issued in FL
Practice address
801 6TH St S
St Petersburg, FL 33701-4816
Phone
(727) 767-4871
NPI assigned
May 9, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Neonatal Nurse Practitioner 363LN0005X ARNP3003172 FL Primary

Addresses

Primary practice location

801 6TH St S
St Petersburg, FL 33701-4816

Mailing address

801 6TH St S
St Petersburg, FL 33701-4816
Phone (727) 767-4871

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
I20180502001662 FL Practitioner - Nurse Practitioner 7719241504 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP3003172FLMDCritical Care Neonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Physician Services, Inc. CurrentSince Mar 14, 2018 Accepting new patients
All Children's OB/GYN Specialists CurrentSince Mar 14, 2018 Accepting new patients
Orlando Health, Inc. Current Accepting new patients
West Coast Neonatology, Inc. CurrentSince Mar 14, 2018 Accepting new patients

Locations

601 5th St S
Ste 5
St Petersburg, FL 33701
Phone (727) 727-4429

501 6th Ave S
St Petersburg, FL 33701
Phone (727) 344-6060

601 5th St S
Ste 504
St Petersburg, FL 33701
Phone (727) 767-7438

801 6th St S
St Petersburg, FL 33701
Phone (727) 767-4141

5959 Central Ave
Ste 103
St Petersburg, FL 33710
Phone (727) 767-6060

Interoperability endpoints

  • Direct secure messaging: ckelly739640@direct.hopkinsmedicine.org
  • Direct secure messaging: ckelly189167@orlandohealth.medalliesdirect.net

Organizations & group practices 4

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": "1210291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210291200000",
    "number": "1912174913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 6TH ST S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014816",
            "telephone_number": "727-767-4871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 6TH ST S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014816",
            "telephone_number": "727-767-4871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "CAROLYN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-09",
        "last_updated": "2008-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "FL",
            "license": "ARNP3003172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.