Jacqueline Kelly, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

D21616 Issued in MD

Practice address

269 Peninsula Farm Rd
Suite F
Arnold, MD 21012-1013

Phone

(410) 518-9808

Fax

(410) 518-9842

NPI assigned

Sep 5, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437609600000",
    "number": "1235231630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "269 PENINSULA FARM RD",
            "address_2": "SUITE F",
            "city": "ARNOLD",
            "state": "MD",
            "postal_code": "210121013",
            "telephone_number": "410-518-9808",
            "fax_number": "410-518-9842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "269 PENINSULA FARM RD",
            "address_2": "SUITE F",
            "city": "ARNOLD",
            "state": "MD",
            "postal_code": "210121013",
            "telephone_number": "410-518-9808",
            "fax_number": "410-518-9842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JACQUELINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-05",
        "last_updated": "2015-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D21616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "790131300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jodi Katzen, MA., CCC-SLP
• Simon Keegan
• Kelly Chiropractic Center, P.a.
• Kelly Hunt FNP-C
• Diane Salmon Kelly, D.C.
• Kent Island Chiropractic PA
• Devin Wade Kiessling, LCSW-C
• Rosa Kim
• Julia Kimbrough, CRNP
• Kelly Lynn Kimmel, ATC

• Pediatrics Physician in Arnold, MD
• Providers in Arnold, MD by specialty
• Pediatrics Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2015; 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.