Kelli Henderson, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA30734 Issued in FL

Practice address

1804 Oakley Seaver Dr
Clermont, FL 34711-1925

Phone

(352) 989-5838

NPI assigned

Dec 20, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kelli McCauley Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1734652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1962210161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15209 SERENADE DR",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347875500",
            "telephone_number": "407-538-4375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1804 OAKLEY SEAVER DR",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347111925",
            "telephone_number": "352-989-5838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "KELLI",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-20",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA30734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLI",
            "last_name": "MCCAULEY",
            "credential": "PTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Hanna L Heberling
• Christopher Heffernan
• Mark A. Hegetschweiler, O.D.
• Caroline Helgeland, DPT
• Cody Helgeland, DPT
• Timothy James Henne, D.P.M.
• Rona Ingrid Henriques, LCSW
• Deloris L Henry
• Kevin Hereman
• Rohinie Hereman, ARNP

• Physical Therapy Assistant in Clermont, FL
• Providers in Clermont, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2024; 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.