Active NPI
Kevin Michael Kelly, DC
- Chiropractor
- Lawndale, CA
National Provider Identifier
1083874846
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC17725
- Practice address
- 15901 Hawthorne Blvd
Suite 420
Lawndale, CA 90260-2655 - Phone
- (805) 496-6104
- Fax
- (805) 496-6144
- NPI assigned
- Jun 13, 2008
- Sex
- Male
- Sole proprietor
- No
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 | DC17725 | CA | Primary |
Addresses
Primary practice location
15901 Hawthorne Blvd
Suite 420
Lawndale, CA 90260-2655
Mailing address
233 E Thousand Oaks Blvd
Suite 420
Thousand Oaks, CA 91360
Phone (805) 496-6104
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC17725 | CA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kevin M Kelly Chiropractic Inc | Chiropractor | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Chiropractor
- Lawndale, CA
- NPI 1922374958
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1332460800000",
"number": "1083874846",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "233 E THOUSAND OAKS BLVD",
"address_2": "SUITE 420",
"city": "THOUSAND OAKS",
"state": "CA",
"postal_code": "91360",
"telephone_number": "805-496-6104",
"fax_number": "805-496-6144"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15901 HAWTHORNE BLVD",
"address_2": "SUITE 420",
"city": "LAWNDALE",
"state": "CA",
"postal_code": "902602655",
"telephone_number": "805-496-6104",
"fax_number": "805-496-6144"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "KEVIN",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-06-13",
"last_updated": "2012-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC17725",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lawndale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.