Thomas Michael Kelley Jr.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

267056 Issued in NC

Practice address

2817 Rock Merritt Ave
Fort Bragg, NC 28310-7324

Phone

(910) 907-7624

NPI assigned

Jun 25, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NC, SC2 enrollments

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 2

Specialty

General Surgery

Education

Temple University School of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Scotland Memorial Hospital, IncGroup PAC ID 0648208504, 259 clinicians

McLeod Physician Associates IIGroup PAC ID 8224031307, 541 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Scotland Memorial Hospital Inc

  • Vascular Surgery Physician
  • Laurinburg, NC
  • NPI 1477791507
  Medicare reassignment Care Compare group NPD
• McLeod Physician Associates II

  • Family Medicine Physician
  • Florence, SC
  • NPI 1801990494

  Surgery

  Medicare reassignment Care Compare group NPD
• Pinehurst Surgical Clinic PA

  • Surgery Physician
  • Pinehurst, NC
  • NPI 1962434324
  Medicare reassignment NPD
• Scotland Memorial Hospital Inc

  • Surgery Physician
  • Laurinburg, NC
  • NPI 1104918754
  NPD
• McLeod Physician Associates II

  • Orthopaedic Surgery Physician
  • Florence, SC
  • NPI 1922555739
  NPD
• McLeod Physician Associates II

  • Family Medicine Physician
  • Dillon, SC
  • NPI 1568434249
  NPD (past)

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

{
    "created_epoch": "1403654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1154736437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 ROCK MERRIT AVE",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283107324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 ROCK MERRITT AVE",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283107324",
            "telephone_number": "910-907-7624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "THOMAS",
        "middle_name": "MICHAEL",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-25",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "74379",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "267056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Kassop, M.D.
• Janice Elaine Katz, M.D.
• Kathryn A.W. Katz, PA-C
• Charmaine Fiona Kaula
• Richard Keezer, PSY.D.
• Matthew Charles Kelly, M.D.
• William Ayers Kelly IV, ATC
• Rhonda Rochelle Kennedy, LCSW
• Savannah Kenny, MAT, LAT, ATC
• Elizabeth Marie Kern, PA-C

• Surgery Physician in Fort Bragg, NC
• Providers in Fort Bragg, NC by specialty
• Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2025; 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.