NPIMap

Organization Active NPI

Timothy M Kelley DC PLLC

  • Clinic/Center
  • Heuvelton, NY
National Provider Identifier
1104093749
Registry record updated May 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
X011547-1 Issued in NY
Legal business name
TIMOTHY M KELLEY DC PLLC
Practice address
94 State St
Heuvelton, NY 13654
Phone
(315) 344-7296
Fax
(315) 344-7296
NPI assigned
May 13, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2008

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

Authorized official

Name
Dr. Timothy Michael Kelley Jr., DC
Title
Owner
Phone
(315) 344-7296

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X X011547-1 NY Primary

Addresses

Primary practice location

94 State St
Heuvelton, NY 13654

Mailing address

94 State St
Heuvelton, NY 13654
Phone (315) 344-7296

Other names 1

  • North Country Chiropractic Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1210636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210636800000",
    "number": "1104093749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94 STATE ST",
            "city": "HEUVELTON",
            "state": "NY",
            "postal_code": "13654",
            "telephone_number": "315-344-7296",
            "fax_number": "315-344-7296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 STATE ST",
            "city": "HEUVELTON",
            "state": "NY",
            "postal_code": "13654",
            "telephone_number": "315-344-7296",
            "fax_number": "315-344-7296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMOTHY M KELLEY DC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-13",
        "last_updated": "2008-05-13",
        "status": "A",
        "authorized_official_last_name": "KELLEY",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-344-7296",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NY",
            "license": "X011547-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Country Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Heuvelton, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2008; 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.