Active NPI
Ronnie E. Kelly, LMBT
- Specialist
- Sylva, NC
National Provider Identifier
1093957599
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 3779
- Practice address
- 23 Hensley Cir
Suite D
Sylva, NC 28779-2834 - Phone
- (828) 586-5333
- NPI assigned
- Mar 30, 2009
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Specialist | 174400000X | 3779 | NC | Primary |
Addresses
Primary practice location
23 Hensley Cir
Suite D
Sylva, NC 28779-2834
Mailing address
41 Iceburg LN
Sylva, NC 28779-8780
Phone (828) 506-7010
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 |
|---|---|---|---|
| 3779 | NC | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1238371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1238371200000",
"number": "1093957599",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "41 ICEBURG LN",
"city": "SYLVA",
"state": "NC",
"postal_code": "287798780",
"telephone_number": "828-506-7010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23 HENSLEY CIR",
"address_2": "SUITE D",
"city": "SYLVA",
"state": "NC",
"postal_code": "287792834",
"telephone_number": "828-586-5333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "RONNIE",
"middle_name": "E.",
"credential": "LMBT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-03-30",
"last_updated": "2009-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NC",
"license": "3779",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sylva, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.