NPIMap

Organization Active NPI

Brooke Kelly, DO, PC

  • Physical Medicine & Rehabilitation Physician
  • Jamestown, NY
National Provider Identifier
1255513313
Registry record updated Jun 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
206222 Issued in NY
Legal business name
BROOKE KELLY, DO, PC
Practice address
774 Fairmount Ave
Jamestown, NY 14701-2609
Phone
(716) 664-7558
Fax
(716) 664-7559
NPI assigned
Nov 30, 2007
Last updated
Jun 13, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2008

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

Authorized official

Name
Brooke K Kelly, DONPI 1558313999
Title
President
Phone
(716) 664-7558

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 206222 NY Primary

Addresses

Primary practice location

774 Fairmount Ave
Jamestown, NY 14701-2609

Mailing address

PO Box 1258
Jamestown, NY 14702-1258
Phone (716) 487-1124

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1196380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213315200000",
    "number": "1255513313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1258",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147021258",
            "telephone_number": "716-487-1124",
            "fax_number": "716-487-2488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "774 FAIRMOUNT AVE",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147012609",
            "telephone_number": "716-664-7558",
            "fax_number": "716-664-7559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKE KELLY, DO, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-30",
        "last_updated": "2008-06-13",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "BROOKE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "716-664-7558",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "206222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamestown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2008; 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.