Individual provider Active NPI

Adrienne Keely, NP-C

  • Family Nurse Practitioner
  • Panama City, FL
National Provider Identifier
1912454828
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11012628 Issued in FL
Practice address
1900 Harrison Ave
Panama City, FL 32405-4542
Phone
(850) 769-7546
NPI assigned
Sep 8, 2016
Last updated
Jun 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-143648 AL
Family Nurse Practitioner 363LF0000X APRN11012628 FL Primary

Addresses

Primary practice location

1900 Harrison Ave
Panama City, FL 32405-4542

Mailing address

1900 Harrison Ave
Panama City, FL 32405-4542
Phone (850) 769-7546

Other practice location 1

1733 W Main St Ste 500
Dothan, AL 36301-1321
Phone (334) 699-7546

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20161012000665 AL Practitioner - Nurse Practitioner 6709174451 Reassigns benefits to 1 organization
I20250225003720 FL Practitioner - Nurse Practitioner 6709174451 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1733 W Main St
Suite 500
Dothan, AL 36301-1321
Phone (334) 699-7546

1900 Harrison Ave
Panama City, FL 32405-4542
Phone (850) 769-1668

Merit-based Incentive Payment System (MIPS)

Final score
93.74 of 100Reported as group
Quality
100
Improvement activities
40
Cost
79.14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1-143648ALMDFamily Nurse Practitioner
APRN11012628FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Associates of Bay County, P.a. CurrentSince Dec 9, 2024 Accepting new patients
Cutaneous Oncology & Surgery Center, LLC Past Accepting new patients

Locations

1733 W Main St
Ste 500
Dothan, AL 36301
Phone (334) 699-7546

1900 Harrison Ave
Panama City, FL 32405
Phone (850) 769-7546

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1473292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1912454828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 HARRISON AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054542",
            "telephone_number": "850-769-7546",
            "fax_number": "850-785-2123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 HARRISON AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054542",
            "telephone_number": "850-769-7546"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1733 W Main St Ste 500",
            "address_purpose": "LOCATION",
            "city": "Dothan",
            "state": "AL",
            "postal_code": "363011321",
            "country_code": "US",
            "telephone_number": "334-699-7546",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEELY",
        "first_name": "ADRIENNE",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-08",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-143648",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11012628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

Verify at the official NPI Registry.