Eric James Kelly, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C007238 Issued in NC

Practice address

3801 Lake Boone TRL
Suite 150
Raleigh, NC 27607-2934

Phone

(919) 210-2070

NPI assigned

Dec 11, 2012

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

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

University of North Carolina at Chapel Hill School of Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Avance Care PAGroup PAC ID 3577634476, 244 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Avance Care, PA

  • Clinic/Center
  • Fuquay Varina, NC
  • NPI 1487845020
  Medicare reassignment Care Compare group NPD
• Monarch

  • Community/Behavioral Health Agency
  • Albemarle, NC
  • NPI 1801116405
  Medicare reassignment NPD
• Monarch

  • Community/Behavioral Health Agency
  • Wilmington, NC
  • NPI 1073267126
  NPD
• Monarch

  • Community/Behavioral Health Agency
  • Albemarle, NC
  • NPI 1972644334
  NPD

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

{
    "created_epoch": "1355184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355184000000",
    "number": "1154666576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 LAKE BOONE TRL",
            "address_2": "SUITE 150",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276072934",
            "telephone_number": "919-210-2070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 LAKE BOONE TRL",
            "address_2": "SUITE 150",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276072934",
            "telephone_number": "919-210-2070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "ERIC",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-11",
        "last_updated": "2012-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C007238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexis Keith Kelly, PA-C
• Anne Louise Kelly, RD
• Christopher Rehbeck Kelly, MD
• Chyra Kelly
• Elizabeth Ann Kelly, PT
• Jalisa Brianne Kelly, MD
• Jennifer Ford Kelly, MED, EDS, LPC
• Jessica L Kelly, BA SLP/A, MS, ITFS
• Juliet Morgan Kelly, PA-C
• Kandis Kelly, LCSWA

• Clinical Social Worker in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.