NPIMap

Individual provider Active NPI

Todd Lawrence Kelly, MD

  • Critical Care Medicine (Anesthesiology) Physician
  • Pinehurst, NC
National Provider Identifier
1306927900
Registry record updated Jun 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Anesthesiology) PhysicianTaxonomy code 207LC0200X
License
2019-00087 Issued in NC
Practice address
155 Memorial Dr
Pinehurst, NC 28374-8710
Phone
(910) 715-2164
NPI assigned
Oct 18, 2006
Last updated
Jun 14, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X K8775 TX
Critical Care Medicine (Anesthesiology) Physician 207LC0200X K8775 TX
Critical Care Medicine (Anesthesiology) Physician 207LC0200X 2019-00087 NC Primary

Addresses

Primary practice location

155 Memorial Dr
Pinehurst, NC 28374-8710

Mailing address

PO Box 840853
Dallas, TX 75284-0853
Phone (713) 620-4000

Other identifiers 7

IdentifierTypeStateIssuer
037266604MedicaidTX
8AC774OtherTXBLUE CROSS
1888397MedicaidLA
37266601MedicaidTX
037266605MedicaidTX
1306927900MedicaidNC
P00616427OtherTXMEDICARE RAILROAD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address TKELLY815054@DIRECT.NOVANTHEALTH.ORG

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190626000313 NC Practitioner - Critical Care (Intensivists)Practitioner - Anesthesiology 2365527579 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Anesthesiology
Education
University of Texas Medical School at Houston, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
FHPG LLCGroup PAC ID 9537481569, 195 clinicians

Practice addresses (Care Compare)

155 Memorial Dr
Pinehurst, NC 28374-8710
Phone (910) 715-2164

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.84 of 100Reported as group
Quality
79.14
Promoting interoperability
92
Improvement activities
40
Cost
80.32

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2019-00087NCMDCritical Care Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
FHPG, LLC Current Accepting new patients
FHPG, LLC CurrentSince Jun 10, 2019 Accepting new patients
U.S. Intensivist Partners Critical Care Medicine Current Accepting new patients
FHPG, LLC CurrentSince Jun 10, 2019 Accepting new patients
CCC - Critical Care Consultants Past Accepting new patients
Sentinel Telemedicine Services, PLLC Critical Care Medicine Past Accepting new patients
Sentinel Anesthesia, PLLC Anesthesiology Past Accepting new patients

Locations

155 Memorial Dr
Pinehurst, NC 28374
Phone (910) 215-1000

6408 Fayetteville Rd
Raeford, NC 28376
Phone (910) 878-6000

925 S Long Dr
Rockingham, NC 28379
Phone (910) 417-3000

520 Allen St
Troy, NC 27371
Phone (910) 571-5000

Interoperability endpoints

  • Direct secure messaging: tkelly815054@direct.novanthealth.org
  • Direct secure messaging: tkelly93955@firsthealth.direct-ci.net

Organizations & group practices 8

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1306927900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840853",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752840853",
            "telephone_number": "713-620-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 MEMORIAL DR",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283748710",
            "telephone_number": "910-715-2164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "TODD",
        "middle_name": "LAWRENCE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "K8775",
            "primary": false
        },
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "TX",
            "license": "K8775",
            "primary": false
        },
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "NC",
            "license": "2019-00087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "037266604",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "8AC774",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1888397",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "37266601",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "037266605",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306927900",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00616427",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "TKELLY815054@DIRECT.NOVANTHEALTH.ORG",
            "affiliation": "N",
            "address_1": "155 Memorial Dr",
            "city": "Pinehurst",
            "state": "NC",
            "country_code": "US",
            "postal_code": "283748710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pinehurst, NC

Sources for this page

Verify at the official NPI Registry.