Thomas N. Kellum, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2554-90 Issued in MS

Practice address

505 Robins St
Tupelo, MS 38804-3715

Phone

(662) 842-8050

Fax

(662) 842-5896

NPI assigned

Jul 28, 2006

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 MS

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Kellum Dental Clinic

  • Dental Clinic/Center
  • Tupelo, MS
  • NPI 1528280880
  NPD (past)

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205840998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1486",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388021486",
            "telephone_number": "662-842-5080",
            "fax_number": "662-842-5896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 ROBINS ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388043715",
            "telephone_number": "662-842-8050",
            "fax_number": "662-842-5896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLUM",
        "first_name": "THOMAS",
        "middle_name": "N.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "2554-90",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew H Kellum, MD
• Daniel H. Kellum, DDS
• Jason Kellum
• Mark J Kellum, MD
• Samantha Kellum, RBT
• Kimberly Ann Kelly, L.P.C
• Morgan Kelly
• Rhonda S Kelly, CRNA
• Brittney Danielle Kelton, FNP-C
• Ken Lippincott, M.D., P.a.

• General Practice Dentistry in Tupelo, MS
• Providers in Tupelo, MS by specialty
• General Practice Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.