NPIMap

Organization Active NPI

Timothy Kelly, Inc.

  • Chiropractor
  • Atlanta, GA
National Provider Identifier
1245448604
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR002569 Issued in GA
Legal business name
TIMOTHY KELLY, INC.
Practice address
3098 Piedmont Rd NE
Suite 430
Atlanta, GA 30305-2600
Phone
(404) 477-1589
Fax
(770) 992-3676
NPI assigned
May 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Authorized official

Name
Timothy P Kelly, DCNPI 1063592558
Title
DC / Owner
Phone
(404) 477-1589

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CHIR002569 GA Primary

Addresses

Primary practice location

3098 Piedmont Rd NE
Suite 430
Atlanta, GA 30305-2600

Mailing address

3098 Piedmont Rd NE
Suite 430
Atlanta, GA 30305-2600
Phone (404) 477-1589

Other names 1

  • D/B/A Timothy P Kelly DC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120503000642 GA Part B Supplier - Clinic/Group Practice 6608038856 Receives reassigned benefits from 1 practitioner
Practice locations: Atlanta, GA

National Provider Directory

National Provider Directory

Locations

3575 Piedmont Rd NE
Bldg 15
Atlanta, GA 30305
Phone (404) 240-2804

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1245448604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3098 PIEDMONT RD NE",
            "address_2": "SUITE 430",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303052600",
            "telephone_number": "404-477-1589",
            "fax_number": "770-992-3676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3098 PIEDMONT RD NE",
            "address_2": "SUITE 430",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303052600",
            "telephone_number": "404-477-1589",
            "fax_number": "770-992-3676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMOTHY KELLY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-18",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "DC / OWNER",
        "authorized_official_telephone_number": "404-477-1589",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR002569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "D/B/A Timothy P Kelly DC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.