Robert Kelly DC LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

2015028621 Issued in MO

Legal business name

ROBERT KELLY DC LLC

Practice address

1722 Boneta Ave
Richmond Heights, MO 63117-2453

Phone

(703) 231-4609

NPI assigned

Feb 18, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Robert Kelly, D.C.

Title

Owner

Phone

(703) 231-4609

Specialties & licenses 1

Addresses

Other names 1

• Robert Kelly DC Doing business as

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

{
    "created_epoch": "1487376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487376000000",
    "number": "1013456482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1722 BONETA AVE",
            "city": "RICHMOND HEIGHTS",
            "state": "MO",
            "postal_code": "631172453",
            "telephone_number": "703-231-4609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1722 BONETA AVE",
            "city": "RICHMOND HEIGHTS",
            "state": "MO",
            "postal_code": "631172453",
            "telephone_number": "703-231-4609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT KELLY DC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-18",
        "last_updated": "2017-02-18",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-231-4609",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MO",
            "license": "2015028621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Robert Kelly DC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Karen M Ramos, MSW, LMSW
• James Redmond
• Katherine Rose Reilly
• Renewed Vitality Home Health Services LLC
• Abdul Rehman Rishi, M.D.
• Ashley Roderick
• Jeramie Lynn Rosales Rodriguez, M.D.
• Alexander Rose, MD, MPHS
• Grayson Rosen, LPC
• Pnina Rothenberg, OTR/L

• Clinic/Center in Richmond Heights, MO
• Providers in Richmond Heights, MO by specialty
• Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2017; 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.