Brian W Kelley, PSYD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

1353 Issued in HI

Practice address

91-2135 Fort Weaver Rd
Suite 501
Ewa Beach, HI 96706-1940

Phone

(808) 312-6800

Fax

(808) 680-0006

NPI assigned

Oct 31, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1351641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415059200000",
    "number": "1104170935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91-2135 FORT WEAVER RD",
            "address_2": "SUITE 501",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967061940",
            "telephone_number": "808-312-6800",
            "fax_number": "808-680-0006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91-2135 FORT WEAVER RD",
            "address_2": "SUITE 501",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967061940",
            "telephone_number": "808-312-6800",
            "fax_number": "808-680-0006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "BRIAN",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-31",
        "last_updated": "2014-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "HI",
            "license": "1353",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "HI",
            "license": "1353",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheila Katano
• Melvin E Kau, O.D.
• Joey L Keahiolalo
• Pamela Keanini
• Darcyann Emmalani Kela
• Jasmine Marie Kelly, MD
• Russell S Kelly, MD
• Ken Nagahiro
• Crystal Kerson
• Violeta G. Khun

• Clinical Neuropsychologist in Ewa Beach, HI
• Providers in Ewa Beach, HI by specialty
• Clinical Neuropsychologist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2014; 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.