Active NPI
Homer Don Kelly, DVM
- Veterinarian
- Marianna, FL
National Provider Identifier
1952587263
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Veterinarian
- License
- 1953
- Practice address
- 4297 Lafayette Street
Marianna, FL 32446 - Phone
- (850) 526-4031
- Fax
- (850) 526-4021
- NPI assigned
- Jan 16, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Veterinarian | 174M00000X | 1953 | FL | Primary |
Addresses
Primary practice location
4297 Lafayette Street
Marianna, FL 32446
Mailing address
4297 Lafayette Street
Marianna, FL 32446
Phone (850) 526-4031
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1953 | FL | MD | Veterinarian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200441600000",
"number": "1952587263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4297 LAFAYETTE STREET",
"city": "MARIANNA",
"state": "FL",
"postal_code": "32446",
"telephone_number": "850-526-4031",
"fax_number": "850-526-4021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4297 LAFAYETTE STREET",
"city": "MARIANNA",
"state": "FL",
"postal_code": "32446",
"telephone_number": "850-526-4031",
"fax_number": "850-526-4021"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "HOMER",
"middle_name": "DON",
"credential": "DVM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-01-16",
"last_updated": "2008-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "174M00000X",
"taxonomy_group": "",
"desc": "Veterinarian",
"state": "FL",
"license": "1953",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marianna, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.