Mara Wells Kelley, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD60170884 Issued in WA

Practice address

4545 Cordata Pkwy
Bellingham, WA 98226-7123

Phone

(360) 738-2200

Fax

(360) 752-5678

NPI assigned

Aug 31, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Mara Wells Volkommer Former name

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mkelley10202@direct.peacehealth.org

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.

• Peacehealth

  • Internal Medicine Physician
  • Bellingham, WA
  • NPI 1356309553

  Pediatrics

  Medicare reassignment NPD
• Peacehealth

  • Sleep Disorder Diagnostic Clinic/Center
  • Bellingham, WA
  • NPI 1265692842
  NPD
• Peacehealth

  • Rural Acute Care Hospital
  • Bellingham, WA
  • NPI 1487904546
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290124800000",
    "number": "1104937093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5096",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982275096",
            "telephone_number": "360-738-2200",
            "fax_number": "360-752-5678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 CORDATA PKWY",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982267123",
            "telephone_number": "360-738-2200",
            "fax_number": "360-752-5678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "MARA",
        "middle_name": "WELLS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2010-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "ML20008684",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD60170884",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104937093",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "0212KE",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I AND CRIME VICTIMS",
            "identifier": "0265880",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARA",
            "last_name": "VOLKOMMER",
            "middle_name": "WELLS",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brittany Keeton, LMT
• Mariah Michele Kehoe-Anderson, CP61414758
• Krissy Mae Keiper, LM, MSM
• Cheryl Ann Kellert, M.D.
• Bailey Kelley, LMT
• Mary-Ann Ruth Kelley, CDP
• Betty J. Kellow
• Kelly Lunda Physical Therapy P.S.
• Cameron E Kelly, MHCA
• Jonna M Kelly, PA-C

• Pediatrics Physician in Bellingham, WA
• Providers in Bellingham, WA by specialty
• Pediatrics Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.