ANGELA KELLY (NPI# 1992115547) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992115547 |
| Entity Type | Individual |
| Full Name | ANGELA KELLY |
| Practice Address |
720 Valley Forge Rd Jacksonville FL 32208-3566 |
| Practice Telephone | 9044059681 |
| Mailing Telephone | 9044059681 |
| Enumeration Date | 2014-05-05 |
| Last Update Date | 2014-05-05 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
6906432 | FL | Nursing & Custodial Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285276485 | Angela Wilson Kelly | Counselor | 907 Haviland Dr, Vestavia Hills, AL 35216-2330 | 2019-10-09 |
| 1205180718 | Angela M Kelly | Occupational Therapist | 3261 Hwy 49 South, Va State Home/collins, Collins, MS 39428 | 2012-11-06 |
| 1205899358 | Angela Dawn Kelly | Chiropractor | 4329 Easton Ave, Bethlehem, PA 18020-1431 | 2006-04-10 |
| 1568956373 | Angela Diane Kelly | Counselor | 306 Sw 8th St, Corvallis, OR 97333-4543 | 2018-06-15 |
| 1366963514 | Angela Dawn Kelly | Pharmacist | 555 W Marion Rd, Mount Gilead, OH 43338-1025 | 2017-06-28 |
| 1699015248 | Angela Elena Kelly | Counselor | 520 Dudley St, Roxbury, MA 02119-2769 | 2013-02-19 |
| 1497015143 | Angela K Kelly | Social Worker | 822 Washington St, Montpelier, ID 83254-1423 | 2012-05-28 |
| 1962732784 | Angela Kelly | Community Health Worker | 801 E Chapman Ave, Fullerton, CA 92831-3839 | 2009-12-29 |
| 1851444392 | Angela M Kelly | Speech-Language Pathologist | 17929 Gottschalk Ave, Homewood, IL 60430-1709 | 2007-01-19 |
| 1174671689 | Angela J. Kelly | Nurse Anesthetist, Certified Registered | 320 E North Ave, Pittsburgh, PA 15212-4756 | 2007-01-08 |
| Street Address |
720 VALLEY FORGE RD |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32208-3566 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245845379 | Lameka Williams | Adult Companion | 6854 Cartier Cir, Jacksonville, FL 32208 | 2020-09-15 |
| 1386173722 | Danielle Mathews | Home Health | 6824 Barberie St., Jacksonville, FL 32208 | 2017-06-08 |
| 1063957520 | Crystal Tramaine Simmons | Licensed Practical Nurse | 3190 Sedona Trl, Jacksonville, FL 32208 | 2016-12-19 |
| 1508316084 | Melissa Angel | Emergency Medical Technician, Basic | 3701 Winton Drive, Jacksonville, FL 32208 | 2016-10-10 |
| 1093176828 | Stephanie Fears | Chore Provider | 5910 Droad St, Jacksonville, FL 32208 | 2016-03-07 |
| 1841676558 | Elizabeth Ann Miller | Social Worker | 1255 Lila Ave, Jacksonville, FL 32208 | 2015-08-04 |
| 1861877698 | Sara Castro | Counselor | 1110 Edgewood Ave West, Jacksonville, FL 32208 | 2015-07-22 |
| 1215352703 | Luther Quarles Iv | Family Medicine | 1760 Edgewood Ave W Ste A&b, Jacksonville, FL 32208 | 2014-02-20 |
| 1356776348 | Top of The Line Mobile Service | Durable Medical Equipment & Medical Supplies | 2252 4th Avenue, Jacksonville, FL 32208 | 2013-09-09 |
| 1437419124 | Carmelita Patrice Rowell | Specialist | 2255 Soutel Dr, Jacksonville, FL 32208 | 2012-05-29 |
| Find all providers in zip 32208 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710512918 | Westwood Manor Residential Care Home LLC | Custodial Care Facility | 5118 Bilken Dr E, Jacksonville, FL 32210-6348 | 2020-03-08 |
| 1770128159 | Christine Ann Mentz | Custodial Care Facility | 13903 Ascot Dr, Jacksonville, FL 32250-1603 | 2019-11-09 |
| 1316430275 | Mary Seeram | Custodial Care Facility | 4313 Savannah Ave, Jacksonville, FL 32210-7307 | 2018-06-14 |
| 1205366895 | Lilibeth Bundang Adona | Custodial Care Facility | 1818 Townsend Blvd, Jacksonville, FL 32211 | 2017-06-15 |
| 1336677921 | Daniel Dowdell | Custodial Care Facility | 1214 Saint Clair St, Jacksonville, FL 32254-2456 | 2017-05-26 |
| 1134670821 | Morine Lee | Custodial Care Facility | 1804 University Blvd N, Jacksonville, FL 32211-4524 | 2016-10-18 |
| 1457800708 | T & T Loving Care Home, Inc. | Custodial Care Facility | 7106 Berrywood Ln, Jacksonville, FL 32277-2609 | 2016-09-28 |
| 1922554252 | Debra Richards | Custodial Care Facility | 14121 Devan Lee Dr W, Jacksonville, FL 32226 | 2016-08-28 |
| 1508222779 | Abbey-gale Samantha Harper | Custodial Care Facility | 15751 Twin Creek Dr, Jacksonville, FL 32218-8337 | 2016-01-04 |
| 1790152866 | Sabrinas Love and Care | Custodial Care Facility | 1701 Lake Shore Blvd Apt 2202, Jacksonville, FL 32210-1669 | 2015-08-25 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32208 |
Please comment or provide details below to improve the information on ANGELA KELLY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.