Active NPI
Joseph Kelly, DC
- Chiropractor
- Beaver, PA
National Provider Identifier
1104877463
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC008952
- Practice address
- 4425 Dutch Ridge Rd
Beaver, PA 15009 - Phone
- (724) 495-3313
- Fax
- (724) 495-3329
- NPI assigned
- May 12, 2006
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC008952 | PA | Primary |
Addresses
Primary practice location
4425 Dutch Ridge Rd
Beaver, PA 15009
Mailing address
4425 Dutch Ridge Rd
Beaver, PA 15009
Phone (724) 495-3313
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040427001180 | PA | Practitioner - Chiropractic | 3476540964 | Practice locations: Beaver, PA |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- New York Chiropractic College, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
4425 Dutch Ridge Rd
Beaver, PA 15009-8531
Phone (724) 495-3313
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351468800000",
"number": "1104877463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4425 DUTCH RIDGE RD",
"city": "BEAVER",
"state": "PA",
"postal_code": "15009",
"telephone_number": "724-495-3313",
"fax_number": "724-495-3329"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4425 DUTCH RIDGE RD",
"city": "BEAVER",
"state": "PA",
"postal_code": "15009",
"telephone_number": "724-495-3313",
"fax_number": "724-495-3329"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "JOSEPH",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-12",
"last_updated": "2012-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "PA",
"license": "DC008952",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaver, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.