Gregory Paul Kelley, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2127 Issued in OK

Practice address

13190 NE 23Rd St
Choctaw, OK 73020-8621

Phone

(405) 769-7201

Fax

(405) 769-4034

NPI assigned

Jun 20, 2006

Sex

Male

Sole proprietor

No

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

• The Physicians Group LLC

  • General Practice Physician
  • Oklahoma City, OK
  • NPI 1487620381

  Family Medicine, OK

  Medicare reassignment NPD
• Gregory P. Kelley D.O. Inc.

  • Family Medicine Physician
  • Choctaw, OK
  • NPI 1689768285

  Family Medicine

  NPD (past)
• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)

Medicare fee-for-service enrollment

Enrolled in OK

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 31, 2015.

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438300800000",
    "number": "1043256019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14024 QUAIL POINTE DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731341006",
            "telephone_number": "405-419-8447",
            "fax_number": "405-419-7745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13190 NE 23RD ST",
            "city": "CHOCTAW",
            "state": "OK",
            "postal_code": "730208621",
            "telephone_number": "405-769-7201",
            "fax_number": "405-769-4034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "GREGORY",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2015-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "2127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Loraina Isabel Jimenez
• Shawnnessy Jiwa, J.D.
• Torion Jones-Deberry
• Stacy Lynn Jones
• Odessa Keen, OTR/L
• Kelli James SLP LLC
• Michaelanne Kelly, PTA
• Jenna Kerdus
• Kimberly Sue Khan, ARNP
• Kandus Kimball

• All providers in Choctaw, OK
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.