Individual provider Active NPI

Keely Iannelli, MD

  • Child Abuse Pediatrics Physician
  • Atlanta, GA
National Provider Identifier
1154884807
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child Abuse Pediatrics PhysicianTaxonomy code 2080C0008X
License
100695 Issued in GA
Practice address
975 Johnson Fy Rd NE Ste 350
Atlanta, GA 30342-4735
Phone
(404) 785-2003
Fax
(404) 785-3850
NPI assigned
Apr 10, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Child Abuse Pediatrics Physician 2080C0008X 100695 GA Primary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 157664 FL

Addresses

Primary practice location

975 Johnson Fy Rd NE Ste 350
Atlanta, GA 30342-4735

Mailing address

975 Johnson Fy Rd NE Ste 350
Atlanta, GA 30342-4735
Phone (404) 785-2003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
157664FLMDPediatrics Physician
100695GAMDChild Abuse Pediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc Single Specialty Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1554854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776729600000",
    "number": "1154884807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 JOHNSON FY RD NE STE 350",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303424735",
            "telephone_number": "404-785-2003",
            "fax_number": "404-785-3850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 JOHNSON FY RD NE STE 350",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303424735",
            "telephone_number": "404-785-2003",
            "fax_number": "404-785-3850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IANNELLI",
        "first_name": "KEELY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-10",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080C0008X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Child Abuse Pediatrics",
            "state": "GA",
            "license": "100695",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "157664",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2026; 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.