Active NPI
Thomas M Kelly, D.C.
- Chiropractor
- Red Bank, NJ
National Provider Identifier
1225050149
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- MC 02233
- Practice address
- 124 State Route 35
Red Bank, NJ 07701-5906 - Phone
- (908) 601-5599
- NPI assigned
- Jul 24, 2006
- Last updated
- Feb 10, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | MC 02233 | NJ | Primary |
Addresses
Primary practice location
124 State Route 35
Red Bank, NJ 07701-5906
Mailing address
124 State Route 35
Red Bank, NJ 07701-5906
Phone (908) 601-5599
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111208000189 | NJ | Practitioner - Chiropractic | 3779758495 | Practice locations: Red Bank, NJ |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 1980
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
124 Hwy 35
Red Bank, NJ 07701-5906
Phone (732) 842-6100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MC 02233 | NJ | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328832000000",
"number": "1225050149",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "124 STATE ROUTE 35",
"city": "RED BANK",
"state": "NJ",
"postal_code": "077015906",
"telephone_number": "908-601-5599"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "124 STATE ROUTE 35",
"city": "RED BANK",
"state": "NJ",
"postal_code": "077015906",
"telephone_number": "908-601-5599"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "THOMAS",
"middle_name": "M",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-24",
"last_updated": "2012-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NJ",
"license": "MC 02233",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Red Bank, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.