# KELLY DARMODY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Antidote Health Co
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710829106
- **Authorized official:** DR. KELLY DARMODY MD (OWNER, CEO)
- **Authorized official phone:** (262) 421-5135

## Contact information

- **Practice address:** 1421 W WASHINGTON ST, WEST BEND, WI 53095-2439
- **Practice address phone:** (262) 421-5135
- **Practice address fax:** (414) 488-1407
- **Mailing address:** 5818 WILDLIFE DR, ALLENTON, WI 53002-9521
- **Mailing address phone:** (262) 421-5135
- **Mailing address fax:** (414) 488-1407

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171400000X | Health & Wellness Coach | — | NULL | — |
| 171400000X | Health & Wellness Coach | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | — |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 04/07/2026
- **Last updated:** 04/07/2026