Active NPI
Richard Amadeus Kelly, D.C.
- Chiropractor
- Cranberry TWP, PA
National Provider Identifier
1023036431
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- AJ-007107-L
- Practice address
- 730 Parkwood Dr
Cranberry TWP, PA 16066-6312 - Phone
- (724) 779-4334
- Fax
- (724) 779-4399
- NPI assigned
- Jul 17, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | AJ-007107-L | PA | Primary |
Addresses
Primary practice location
730 Parkwood Dr
Cranberry TWP, PA 16066-6312
Mailing address
730 Parkwood Dr
Cranberry TWP, PA 16066-6312
Phone (724) 779-4334
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 568795 | Other | PA | HIGHMARK BLUE CROSS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AJ-007107-L | PA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1023036431",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "730 PARKWOOD DR",
"city": "CRANBERRY TWP",
"state": "PA",
"postal_code": "160666312",
"telephone_number": "724-779-4334",
"fax_number": "724-779-4399"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "730 PARKWOOD DR",
"city": "CRANBERRY TWP",
"state": "PA",
"postal_code": "160666312",
"telephone_number": "724-779-4334",
"fax_number": "724-779-4399"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "RICHARD",
"middle_name": "AMADEUS",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "PA",
"license": "AJ-007107-L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BLUE CROSS",
"identifier": "568795",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cranberry TWP, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.