Individual provider Active NPI

Dennis L Kelly, MD

  • Anesthesiology Physician
  • Manchester, NH
National Provider Identifier
1104824093
Registry record updated Mar 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
8710 Issued in NH
Practice address
88 McGregor St
Ste 303
Manchester, NH 03102-3750
Phone
(603) 647-9325
Fax
(603) 647-2453
NPI assigned
Jul 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 8710 NH Primary

Addresses

Primary practice location

88 McGregor St
Ste 303
Manchester, NH 03102-3750

Mailing address

88 McGregor St
Ste 303
Manchester, NH 03102-3750
Phone (603) 647-9325

Other identifiers 1

IdentifierTypeStateIssuer
80002247MedicaidNH

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
8710NHMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Elliot Hospital of the City of Manchester Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395187200000",
    "number": "1104824093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 MCGREGOR ST",
            "address_2": "STE 303",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031023750",
            "telephone_number": "603-647-9325",
            "fax_number": "603-647-2453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 MCGREGOR ST",
            "address_2": "STE 303",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031023750",
            "telephone_number": "603-647-9325",
            "fax_number": "603-647-2453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "DENNIS",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2014-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NH",
            "license": "8710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "80002247",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 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.