KELLY DAVIS ROBERTS LMT - NPI 1114742079 - Massage Therapist in Lake City, FL

Q: What is Kelly Roberts's NPI number?

The NPI number for Kelly Roberts is 1114742079. It was assigned to this individual provider in the NPPES registry on November 16, 2024.

Q: What is Kelly Roberts's specialty?

The primary specialty registered for this NPI is Massage Therapist with taxonomy code 225700000X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Roberts was last updated on June 19, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Kelly Davis Roberts Lmt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY DAVIS ROBERTS LMT (NPI 1114742079) is an individual massage therapist in Lake City, Florida, licensed in Florida (MA64119) and active in the NPI registry since November 2024.

NPPES Registry Identity

NPI1114742079

Entity TypeIndividualFemale

Primary Taxonomy225700000X

Provider Legal NameKELLY DAVIS ROBERTSCredential: LMT

Location Address738 SW MAIN BLVDLake City, FL 32025-5768

Mailing Address434 Se Waldron TerLake City, FL 32025-5529 · (386) 400-3140 · Fax (386) 406-8013

Phone(386) 400-3140

Fax(386) 406-8013

Sole ProprietorYes

Enumeration DateNovember 16, 2024

Last NPPES UpdateJune 19, 20253 updates tracked since enumeration

NPPES CertifiedJune 19, 2025

✔ NPI 1114742079 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy Code225700000X

License✔ Licensed in FL · MA64119

Definition

An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

738 SW MAIN BLVD, Lake City, FL 32025

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