NPIMap

Organization Active NPI

Jean C Kelley, MD

  • Pediatrics Physician
  • Cambridge, MA
National Provider Identifier
1255878922
Registry record updated Jan 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
72752 Issued in MA
Legal business name
JEAN C KELLEY, MD
Practice address
61 Fresh Pond Pkwy
Cambridge, MA 02138-3348
Phone
(781) 856-7993
NPI assigned
Jan 19, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2017

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

Authorized official

Name
Dr. Jean C Kelley, MD
Title
Physician
Phone
(781) 856-7993

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 72752 MA Primary

Addresses

Primary practice location

61 Fresh Pond Pkwy
Cambridge, MA 02138-3348

Mailing address

61 Fresh Pond Pkwy
Cambridge, MA 02138-3348
Phone (781) 856-7993

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1484784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484784000000",
    "number": "1255878922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 FRESH POND PKWY",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021383348",
            "telephone_number": "781-856-7993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 FRESH POND PKWY",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021383348",
            "telephone_number": "781-856-7993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEAN C KELLEY, MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-19",
        "last_updated": "2017-01-19",
        "status": "A",
        "authorized_official_last_name": "KELLEY",
        "authorized_official_first_name": "JEAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "781-856-7993",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "72752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2017; 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.