Michael Thomas Kelly, D.O.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

2011-01909 Issued in NC

Practice address

1900 Electric Rd
Salem, VA 24153-7474

Phone

(817) 284-9850

Fax

(817) 720-9892

NPI assigned

Jun 26, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

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.

• Supriya Ailnani PLLC

  • Internal Medicine Physician
  • Lakeway, TX
  • NPI 1700375433
  NPD (past)
• Victor H Flores MD PLLC

  • Physical Medicine & Rehabilitation Physician
  • Fort Worth, TX
  • NPI 1740848993
  NPD (past)

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559520000000",
    "number": "1063449130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6707 BRENTWOOD STAIR RD STE 600",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761123368",
            "telephone_number": "817-284-9850",
            "fax_number": "817-720-9892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 ELECTRIC RD",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241537474",
            "telephone_number": "817-284-9850",
            "fax_number": "817-720-9892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MICHAEL",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2019-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P0004X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine",
            "state": "NC",
            "license": "2011-01909",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NC",
            "license": "2011-01909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5919524",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeannie Keen, LCSW
• Chandler Elliott Keever, DO
• Renae A Keffer
• Johnna Lynette Kelley, PSY.D.
• Misty Rose Kelley
• James C Kemper, DDS
• Kennedy Chiropractic Inc.
• Jordan Kennedy, LPC
• Mia M Kennedy, DC
• Patrick Kennedy

• Physical Medicine & Rehabilitation Physician in Salem, VA
• Providers in Salem, VA by specialty
• Physical Medicine & Rehabilitation Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2019; 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.