Henry Albert Kelly Jr

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

1046352 Issued in TN

Legal business name

HENRY ALBERT KELLY JR

Practice address

4124 Firwood LN Apt L
Charlotte, NC 28209-2724

Phone

(910) 747-5215

NPI assigned

Apr 9, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Henry Albert Kelly Jr., MHPA, PH.D

Title

Mhpa, PH.D

Phone

(910) 747-5215

Specialties & licenses 1

Addresses

Other names 1

• Kelly & Associates Other name

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

{
    "created_epoch": "1428537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428537600000",
    "number": "1023404704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4124 FIRWOOD LN APT L",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282092724",
            "telephone_number": "910-747-5215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4124 FIRWOOD LN APT L",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282092724",
            "telephone_number": "910-747-5215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENRY ALBERT KELLY JR",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-09",
        "last_updated": "2015-04-09",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "HENRY",
        "authorized_official_middle_name": "ALBERT",
        "authorized_official_title_or_position": "MHPA, PH.D",
        "authorized_official_telephone_number": "910-747-5215",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MHPA, PH.D"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "TN",
            "license": "1046352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kelly & Associates",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kathy A Henricksen, DPM
• Skylar Henrikson
• Beatrice Henriques, NP
• Kimberly Anne Henriquez, CNM
• Sean Henriquez, MSP, CCC-SLP
• Andrew Henry, DMD, MD
• Ann C Henry, PT, DPT, ATC
• Bonnie Henry, MA
• Carolyn Henry
• Gace Renee Henry

• Health Maintenance Organization in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Health Maintenance Organization in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2015; 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.