Judith Amanda Kelley, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

30354 Issued in AZ

Practice address

1020 N San Francisco St
Ste 100
Flagstaff, AZ 86001-3281

Phone

(928) 214-2156

NPI assigned

Aug 5, 2006

Last updated

Jan 11, 2018By the provider in NPPES

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 identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Anesthesiology

Education

University of Michigan Medical School, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ryder Medical PC

  • Anesthesiology Physician
  • Flagstaff, AZ
  • NPI 1497260780
  Medicare reassignment NPD Authorized official
• Forest Country Anesthesia, P.C.

  • Anesthesiology Physician
  • Flagstaff, AZ
  • NPI 1700824406
  NPD (past)

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515628800000",
    "number": "1023027661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2886 W NORIA ST",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860010940",
            "telephone_number": "928-607-3864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 N SAN FRANCISCO ST",
            "address_2": "STE 100",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013281",
            "telephone_number": "928-214-2156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "JUDITH",
        "middle_name": "AMANDA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2018-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "30354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "708274",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elissa M Keel, NP
• Jenny M Keim, PHYSICAL THERAPIST
• Angela Lynn Keith, PHD, LPC
• Danielle Dominique Keller, PA-C
• Sandra Taylor Kellett, PA-C
• Ralph Zane Kelley, DO
• Star Kelley, LCSW
• Kelly Reber DPM, PC (Northern Arizona Podiatry Group)
• Nicole Angela Kelly-Gordon
• Melissa C Kelly, PHARMD

• Anesthesiology Physician in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Anesthesiology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.