Kelley Sports Medicine Inc

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

A78913 Issued in CA

Legal business name

KELLEY SPORTS MEDICINE INC

Practice address

40949 Winchester Rd
Temecula, CA 92591-6031

Phone

(951) 296-6676

Fax

(951) 296-6675

NPI assigned

Jul 31, 2008

Organization subpart

No

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

Authorized official

Name

Steven Thomas Kelley, M.D.NPI 1194733402

Title

President

Phone

(951) 296-6676

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Steven Thomas Kelley, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Temecula, CA
  • NPI 1194733402
  Medicare reassignment Authorized official
• Jacob Vandenmeerendonk, DPT

  • Orthopedic Physical Therapist
  • Murrieta, CA
  • NPI 1639586423
  Medicare reassignment

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

{
    "created_epoch": "1217462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392854400000",
    "number": "1144486903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40949 WINCHESTER RD",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925916031",
            "telephone_number": "951-296-6676",
            "fax_number": "951-296-6675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40949 WINCHESTER RD",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925916031",
            "telephone_number": "951-296-6676",
            "fax_number": "951-296-6675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLEY SPORTS MEDICINE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-31",
        "last_updated": "2014-02-20",
        "status": "A",
        "authorized_official_last_name": "KELLEY",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-296-6676",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "A78913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karmen Kazma, MD
• Seth Kearl
• Nathan C Keast
• Jennifer Leanne Kehoe, CCC-SLP
• Kelley Counseling Licensed Clinical Social Worker Inc
• Daniel Kelley, PMHNP-BC
• Michelle Kelley, LCSW
• Steven Thomas Kelley, M.D.
• Tamara Kelley
• Laura Kellogg

• Orthopaedic Surgery Physician in Temecula, CA
• Providers in Temecula, CA by specialty
• Orthopaedic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.