Individual provider Active NPI

Woodrow Timothy Kelly, DC

  • Chiropractor
  • Richmond Hill, GA
National Provider Identifier
1265549976
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
006850 Issued in GA
Practice address
10164 Ford Ave Ste B
Richmond Hill, GA 31324-3948
Phone
(912) 756-8080
Fax
(912) 756-8170
NPI assigned
Aug 25, 2006
Last updated
Aug 28, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 006850 GA Primary

Addresses

Primary practice location

10164 Ford Ave Ste B
Richmond Hill, GA 31324-3948

Mailing address

10164 Ford Ave Ste B
Richmond Hill, GA 31324-3948
Phone (912) 756-8080

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031107000024 GA Practitioner - Chiropractic 0648182949 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Lincoln Chiropractic College, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9390 Ford Ave
Suite 2
Richmond Hill, GA 31324-3637
Phone (912) 756-8080

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006850GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kelly Chiropractic P C Chiropractor CurrentSince Nov 7, 2003 Accepting new patients

Locations

10164 Ford Ave
Ste B
Richmond Hill, GA 31324
Phone (912) 355-6503

9390 Ford Ave
Ste 2
Richmond Hill, GA 31324
Phone (912) 756-8080

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787875200000",
    "number": "1265549976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10164 FORD AVE STE B",
            "city": "RICHMOND HILL",
            "state": "GA",
            "postal_code": "313243948",
            "telephone_number": "912-756-8080",
            "fax_number": "912-756-8170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10164 FORD AVE STE B",
            "city": "RICHMOND HILL",
            "state": "GA",
            "postal_code": "313243948",
            "telephone_number": "912-756-8080",
            "fax_number": "912-756-8170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "WOODROW",
        "middle_name": "TIMOTHY",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "006850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond Hill, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2026; 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.

Verify at the official NPI Registry.