NPIMap

Individual provider Active NPI

Brian Kelley

  • Student in an Organized Health Care Education/Training Program
  • Chapel Hill, NC
National Provider Identifier
1194213785
Registry record updated Apr 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
50147606 Issued in NC
Practice address
102 Mason Farm Rd
Chapel Hill, NC 27599-6134
Phone
(919) 966-1459
Fax
(919) 843-2356
NPI assigned
Apr 29, 2018
Last updated
Apr 29, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 50147606 NC Primary

Addresses

Primary practice location

102 Mason Farm Rd
Chapel Hill, NC 27599-6134

Mailing address

3133 Napoleon Ave
New Orleans, LA 70125-5119
Phone (318) 572-2829

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250908002678 NC Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 6901153048 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1415 Physicians Dr
Wilmington, NC 28401-7338
Phone (910) 662-9500

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting41
Pacemaker insertion or repair1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
50147606NCMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health New Hanover Regional Medical Center LLC CurrentSince Aug 1, 2025 Accepting new patients
Novant Health New Hanover Regional Medical Center LLC CurrentSince Aug 1, 2025 Accepting new patients
NMG Health Services LLC CurrentSince Jul 15, 2025 Accepting new patients
Brunswick Community Hospital, LLC CurrentSince Aug 1, 2025 Accepting new patients
Pender Memorial Hospital, Incorporated CurrentSince Aug 1, 2025 Accepting new patients
Pender Memorial Hospital Incorporated CurrentSince Aug 1, 2025 Accepting new patients
Novant Health Medical Group Coastal Region, LLC CurrentSince Jul 15, 2025 Accepting new patients
New Hanover Medical Group PA Past Accepting new patients

Locations

240 Hospital Dr NE
Bolivia, NC 28422
Phone (336) 399-7678

257 Hospital Dr NE
Ste 201
Bolivia, NC 28422

507 E Fremont St
Burgaw, NC 28425
Phone (910) 259-5451

800 Jefferson St
Ste 112
Whiteville, NC 28472
Phone (910) 642-8164

1415 Physicians Dr
Wilmington, NC 28401
Phone (910) 251-3766

105 Scotts Hill Medical Dr
Wilmington, NC 28411
Phone (910) 686-2840

Interoperability endpoints

  • Direct secure messaging: bkelley439023@direct.unc.nchie.net
  • Direct secure messaging: bkelley1701700@direct.novanthealth.org

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1524960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524960000000",
    "number": "1194213785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3133 NAPOLEON AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701255119",
            "telephone_number": "318-572-2829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 MASON FARM RD",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275996134",
            "telephone_number": "919-966-1459",
            "fax_number": "919-843-2356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "BRIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-29",
        "last_updated": "2018-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": "50147606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

Verify at the official NPI Registry.