Individual provider Active NPI

Matthew Scott Kelly, M.D., M.P.H.

  • Pediatric Infectious Diseases Physician
  • Little Rock, AR
National Provider Identifier
1306004577
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Infectious Diseases PhysicianTaxonomy code 2080P0208X
License
E-18631 Issued in AR
Practice address
1 Childrens Way # 512-1
Little Rock, AR 72202-3500
Phone
(501) 364-1100
Fax
(501) 364-4082
NPI assigned
May 23, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 442544 PA
Pediatrics Physician 208000000X 232262 MA
Pediatric Infectious Diseases Physician 2080P0208X E-18631 AR Primary

Addresses

Primary practice location

1 Childrens Way # 512-1
Little Rock, AR 72202-3500

Mailing address

1 Childrens Way # 653
Little Rock, AR 72202-3500
Phone (501) 364-1100

Other practice location 1

34th & Civic Center Boulevard
Children's Hospital of Philadelphia
Philadelphia, PA 19104
Phone (215) 590-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, AR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20161101002583 NC Practitioner - Pediatric Medicine 8820376460
I20250204001163 AR Practitioner - Pediatric MedicinePractitioner - Infectious Disease 8820376460 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Infectious Disease
Education
Harvard Medical School, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arkansas Childrens Professional Services Organization LLCGroup PAC ID 4688183148, 180 clinicians

Practice addresses (Care Compare)

1 Childrens Way
Little Rock, AR 72202-3500
Phone (501) 364-2526

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
232262MAMDPediatrics Physician
442544PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences Pediatrics Current Accepting new patients
Arkansas Childrens Hospital Pediatrics CurrentSince Feb 15, 2025 Accepting new patients
Arkansas Children'S Hospital CurrentSince Feb 15, 2025 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Feb 15, 2025 Accepting new patients
Arkansas Childrens Professional Services Organization LLC Pediatrics CurrentSince Jul 1, 2025 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Feb 15, 2025 Accepting new patients

Locations

1 Childrens Way
#664
Little Rock, AR 72202
Phone (501) 364-2505

1 Childrens Way
Little Rock, AR 72202
Phone (501) 364-1874

1 Childrens Way
#653
Little Rock, AR 72202
Phone (501) 614-2006

1 Childrens Way
#5121
Little Rock, AR 72202
Phone (501) 364-5262

1 Childrens Way
Ste 653
Little Rock, AR 72202

Organizations & group practices 6

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": "1211500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1306004577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS WAY # 653",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023500",
            "telephone_number": "501-364-1100",
            "fax_number": "501-364-4082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS WAY # 512-1",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023500",
            "telephone_number": "501-364-1100",
            "fax_number": "501-364-4082"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "34th & Civic Center Boulevard",
            "address_2": "Children's Hospital of Philadelphia",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "19104",
            "country_code": "US",
            "telephone_number": "215-590-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MATTHEW",
        "middle_name": "SCOTT",
        "credential": "M.D., M.P.H.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-23",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "442544",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "232262",
            "primary": false
        },
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "AR",
            "license": "E-18631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.