Gene Kelly, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

L1907 Issued in TX

Practice address

2901 N 4TH St
Longview, TX 75605-5128

Phone

(903) 232-3675

NPI assigned

Feb 12, 2007

Last updated

Mar 20, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

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

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/23550/brand/1/csg/1/fhir/r4

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

• Acs Primary Care Physicians Southwest, PA

  • Emergency Medicine Physician
  • Gainesville, TX
  • NPI 1538101019
  Medicare reassignment NPD
• Diagnostic Clinic of Longview PA

  • Internal Medicine Physician
  • Longview, TX
  • NPI 1386638468
  NPD (past)

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395273600000",
    "number": "1114069895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 847176",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752847176",
            "telephone_number": "903-237-1800",
            "fax_number": "903-237-1810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 N 4TH ST",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756055128",
            "telephone_number": "903-232-3675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "GENE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2014-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "L1907",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "147381103",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "147381101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samwel Kebaya
• Leslie A Keehne, D.C.
• Colin Everett Keller, PA-C
• Janet L. Kelley, MD
• Suzanne Kelley, LCDC
• Jerald Donald Kelly, DC
• Kathy Ann Kelly, LMFT
• Jeffrey Russell Kemp, M.D.
• Lauren Eliazbeth Kemp, RN
• Ken Newton Chiropractic Clinic, LLC

• Emergency Medicine Physician in Longview, TX
• Providers in Longview, TX by specialty
• Emergency Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2014; 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.