Charles E.Kelly & Company

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

Legal business name

CHARLES E.KELLY & COMPANY

Doing business as

Tippin Bank & Trust Company

Practice address

409 Oak St
Claxton, GA 30417-1351

Phone

(912) 739-1122

NPI assigned

Dec 3, 2014

Last updated

Dec 3, 2014By the provider in NPPES

Organization subpart

Yes

Parent organization

GLENVILLE BANKAs reported in NPPES

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

Authorized official

Name

Mr. Charles E Kelly Sr., DOC

Title

Market Communication Specialist

Phone

(912) 739-1122

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• TIPPIN BANK & TRUST COMPANY Doing business as

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

{
    "created_epoch": "1417564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417564800000",
    "number": "1184021347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 OAK ST",
            "city": "CLAXTON",
            "state": "GA",
            "postal_code": "304171351",
            "telephone_number": "912-739-1122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 OAK ST",
            "city": "CLAXTON",
            "state": "GA",
            "postal_code": "304171351",
            "telephone_number": "912-739-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES E.KELLY & COMPANY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GLENVILLE BANK",
        "enumeration_date": "2014-12-03",
        "last_updated": "2014-12-03",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MARKET COMMUNICATION SPECIALIST",
        "authorized_official_telephone_number": "912-739-1122",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "DOC"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "GA",
            "license": null,
            "primary": true
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY AUTHORITY",
            "identifier": "1399374",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TIPPIN BANK & TRUST COMPANY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Preferred Provider Organization in Claxton, GA
• Providers in Claxton, GA by specialty
• Preferred Provider Organization in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2014; 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.