Gordon Neil Kellett II, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

0101025852 Issued in VA

Practice address

13821 Village Mill Dr
Midlothian, VA 23114-4365

Phone

(804) 794-2821

Fax

(804) 794-4072

NPI assigned

Jul 31, 2006

Last updated

Jan 12, 2009By 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 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Pediatric & Adolescent Health Partners, P.C.

  • Pediatrics Physician
  • Midlothian, VA
  • NPI 1851458178
  NPD (past)

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231718400000",
    "number": "1114933298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 549",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231130549",
            "telephone_number": "804-794-2821",
            "fax_number": "804-794-4072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13821 VILLAGE MILL DR",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231144365",
            "telephone_number": "804-794-2821",
            "fax_number": "804-794-4072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLETT",
        "first_name": "GORDON",
        "middle_name": "NEIL",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2009-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101025852",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "1200296",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "11360",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTHERN HEALTH",
            "identifier": "128503",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "217017",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARENT",
            "identifier": "21688",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006703941",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Derek Kegyeda
• Hamilton Keith, PT
• Kevin Erick Kelleher, D.M.D
• Jennifer Pillard Keller, BCBA
• Kevin Achille Keller, MD
• Alesha Nicol Kelley, COTA/L
• Ashley Redden Kelley, DPT
• Jason Kelley, PT, DPT
• Celeste Macdonald Kelly, PSYD
• James A Kelly, DDS

• Pediatrics Physician in Midlothian, VA
• Providers in Midlothian, VA by specialty
• Pediatrics Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2009; 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.