Individual provider Active NPI

Gabriel Alexander Kelly, DC

  • Chiropractor
  • Atlanta, GA
National Provider Identifier
1316655913
Registry record updated Nov 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR010898 Issued in GA
Practice address
3575 Piedmont Rd NE Ste P130
Atlanta, GA 30305-1684
Phone
(404) 477-1589
NPI assigned
Nov 11, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR010898 GA Primary

Addresses

Primary practice location

3575 Piedmont Rd NE Ste P130
Atlanta, GA 30305-1684

Mailing address

3575 Piedmont Rd NE Ste P130
Atlanta, GA 30305-1684

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CHIR010898GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Timothy Kelly, Inc. Chiropractor CurrentSince Mar 15, 2024 Accepting new patients
Gabriel a Kelly, LLC Chiropractor CurrentSince Apr 21, 2024 Accepting new patients

Locations

3575 Piedmont Rd NE
Ste P130
Atlanta, GA 30305
Phone (404) 477-1589

Organizations & group practices 2

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": "1668124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668124800000",
    "number": "1316655913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3575 PIEDMONT RD NE STE P130",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303051684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3575 PIEDMONT RD NE STE P130",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303051684",
            "telephone_number": "404-477-1589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "GABRIEL",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-11",
        "last_updated": "2022-11-11",
        "certification_date": "2022-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR010898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2022; 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.