William Kelly, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

105766 Issued in MO

Practice address

941 E Hubble Dr
Marshfield, MO 65706-2538

Phone

(417) 269-1940

Fax

(417) 269-1948

NPI assigned

Oct 13, 2006

Last updated

Sep 12, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MO

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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

• Lester E. Cox Medical Centers

  dba Shell Knob Family Medicine

  • Family Medicine Physician
  • Shell Knob, MO
  • NPI 1538334396
  Medicare reassignment NPD
• Lester E Cox Medical Centers

  dba CoxHealth Neurology

  • Neurology Physician
  • Springfield, MO
  • NPI 1023763414
  NPD
• Lester E Cox Medical Centers

  dba CoxHealth COVID Support

  • Clinic/Center
  • Springfield, MO
  • NPI 1447905633
  NPD
• Lester E Cox Medical Centers

  dba Cox Medical Centers

  • Family Medicine Physician
  • Springfield, MO
  • NPI 1922126077
  NPD

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473638400000",
    "number": "1093805087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 S NATIONAL AVE",
            "address_2": "#540",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075209",
            "telephone_number": "417-269-1940",
            "fax_number": "417-269-1948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "941 E HUBBLE DR",
            "city": "MARSHFIELD",
            "state": "MO",
            "postal_code": "657062538",
            "telephone_number": "417-269-1940",
            "fax_number": "417-269-1948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2016-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "105766",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCMO",
            "identifier": "107908",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208663419",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alissa Marie Johnson, PTA
• Christopher Michael Johnson, PTA
• Elizabeth Fae Johnston, PTA
• Chelsea R Joy, PHARMD
• Kansas City Vamc
• Tiffany Renee Kirk
• Kramer & Newcomb O.D., P.C. (Marshfield Eye Clinic)
• Coral J Krueger, MSW, LCSW
• Lace Counseling Center LLC
• Daryl E Lace, LPC

• Family Medicine Physician in Marshfield, MO
• Providers in Marshfield, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2016; 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.