Kristopher J. Kelly LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

35087489 Issued in OH

Legal business name

KRISTOPHER J. KELLY LLC

Practice address

5655 Monclova Rd
Maumee, OH 43537-1870

Phone

(419) 893-4883

Fax

(419) 893-2312

NPI assigned

May 12, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Kristopher J Kelly, M.D.

Title

Owner

Phone

(419) 893-4883

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1336780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336780800000",
    "number": "1083973903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5655 MONCLOVA RD",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435371870",
            "telephone_number": "419-893-4883",
            "fax_number": "419-893-2312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5655 MONCLOVA RD",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435371870",
            "telephone_number": "419-893-4883",
            "fax_number": "419-893-2312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRISTOPHER J. KELLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-12",
        "last_updated": "2012-05-12",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "KRISTOPHER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "419-893-4883",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "OH",
            "license": "35087489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charlotte E Kramer, SLP
• Richard Krasula, PTA
• Frances Kraus, RBT
• Alleynah Marie Kreglow, RN
• Kimberly Krese
• Nicole Kruse
• Elizabeth Kuehn, SLP
• Jeremy Kwiatkowski, LPC
• Nabil V Lama
• Melanie Lamb, LSW

• Specialist in Maumee, OH
• Providers in Maumee, OH by specialty
• Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 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.

Verify at the official NPI Registry.