Eleanor Kelly, MD, Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A064544 Issued in CA

Legal business name

ELEANOR KELLY, MD, INC

Practice address

1 Hoag Dr
Newport Beach, CA 92663-4162

Phone

(949) 735-0174

Fax

(949) 854-7143

NPI assigned

Feb 13, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Eleanor Marie Kelly, MD

Title

Director

Phone

(949) 735-0174

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451260800000",
    "number": "1114069549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 BIRCH ST",
            "address_2": "2ND FLOOR",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602160",
            "telephone_number": "949-735-0174",
            "fax_number": "949-854-7143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOAG DR",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926634162",
            "telephone_number": "949-735-0174",
            "fax_number": "949-854-7143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEANOR KELLY, MD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2015-12-28",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "ELEANOR",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "949-735-0174",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A064544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2015; 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.