Active NPI
David Charles Kelly Jr.
- Nuclear Medicine Technology Radiologic Technologist
- Blue Ash, OH
National Provider Identifier
1104014299
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nuclear Medicine Technology Radiologic Technologist
- License
- N8861468
- Practice address
- 8915 Cherry St
Blue Ash, OH 45242-7846 - Phone
- (937) 232-4496
- NPI assigned
- Oct 15, 2007
- 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 |
|---|---|---|---|---|
| Nuclear Medicine Technology Radiologic Technologist | 2471N0900X | N8861468 | OH | Primary |
Addresses
Primary practice location
8915 Cherry St
Blue Ash, OH 45242-7846
Mailing address
8915 Cherry St
Blue Ash, OH 45242-7846
Phone (937) 232-4496
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 |
|---|---|---|---|
| N8861468 | OH | MD | Nuclear Medicine Technology Radiologic Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1192406400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192406400000",
"number": "1104014299",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8915 CHERRY ST",
"city": "BLUE ASH",
"state": "OH",
"postal_code": "452427846",
"telephone_number": "937-232-4496"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8915 CHERRY ST",
"city": "BLUE ASH",
"state": "OH",
"postal_code": "452427846",
"telephone_number": "937-232-4496"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "DAVID",
"middle_name": "CHARLES",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-10-15",
"last_updated": "2007-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "2471N0900X",
"taxonomy_group": "",
"desc": "Radiologic Technologist, Nuclear Medicine Technology",
"state": "OH",
"license": "N8861468",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Blue Ash, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.