Individual provider Active NPI

John D Kelly, MD

  • Emergency Medicine Physician
  • Washington, DC
National Provider Identifier
1285685768
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD33568 Issued in DC
Practice address
1310 Southern Ave SE
Washington, DC 20032-4699
Phone
(202) 574-6000
NPI assigned
May 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD33568 DC Primary

Addresses

Primary practice location

1310 Southern Ave SE
Washington, DC 20032-4699

Mailing address

1621 S St NW
#3
Washington, DC 20009-6445
Phone (202) 234-8299

Other identifiers 1

IdentifierTypeStateIssuer
CS0212562OtherDCCDS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040729000597 DC Practitioner - Emergency Medicine 3072583731 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD33568DCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Associates P.a., P.C. CurrentSince May 1, 2015 Accepting new patients
Emergency Medicine Associates P.a., P.C. Emergency Medicine CurrentSince May 1, 2015 Accepting new patients
National Emergency Services District of Columbia Inc Emergency Medicine Past Accepting new patients
Anacostia River Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Inphynet Contracting Services LLC Emergency Medicine Past Accepting new patients

Locations

5255 Loughboro Rd NW
Washington, DC 20016
Phone (202) 243-2280

20010 Century Blvd
Ste 200
Germantown, MD 20874

1701 N George Mason Dr
Arlington, VA 22205
Phone (703) 558-5000

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1285685768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1621 S ST NW",
            "address_2": "#3",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200096445",
            "telephone_number": "202-234-8299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 SOUTHERN AVE SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200324699",
            "telephone_number": "202-574-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JOHN",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "DC",
            "license": "MD33568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDS",
            "identifier": "CS0212562",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.