J&S Kelly LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

W00200148 Issued in IA

Legal business name

J&S KELLY LLC

Doing business as

Kellys Medical Equipment & Supply

Practice address

730 E Kimberly Rd
Davenport, IA 52807-1621

Phone

(563) 386-1553

Fax

(563) 449-5450

NPI assigned

Jun 20, 2005

Organization subpart

No

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

Authorized official

Name

Mr. William M Kellenberger

Title

Managing Member

Phone

(563) 386-1553

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kellys Medical Equipment & Supply Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• J & S Kelly Galesburg L.L.C.

  • Oxygen Equipment & Supplies (DME)
  • Galesburg, IL
  • NPI 1942231287

  Member Of

  NPD member

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• J & S Kelly Galesburg L.L.C.

  • Oxygen Equipment & Supplies (DME)
  • Galesburg, IL
  • NPI 1942231287

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332892800000",
    "number": "1316942915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 E KIMBERLY RD",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528071621",
            "telephone_number": "563-386-1553",
            "fax_number": "563-449-5450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 E KIMBERLY RD",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528071621",
            "telephone_number": "563-386-1553",
            "fax_number": "563-449-5450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J&S KELLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-20",
        "last_updated": "2012-03-28",
        "status": "A",
        "authorized_official_last_name": "KELLENBERGER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "563-386-1553",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IA",
            "license": "W00200148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0185272",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kellys Medical Equipment & Supply",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Penny Marie Irish, LMT
• Laura Irwin
• Virgie Lavette Islas, OTR/L
• Haruyo Izumi, A.T.C.
• J&S Kelly LLC
• Tara Marie Jacks
• Jackson Recovery Centers
• Catherine DO Jackson, PHD
• Christa Jackson
• Liyah Jackson

• Durable Medical Equipment & Medical Supplies in Davenport, IA
• Providers in Davenport, IA by specialty
• Durable Medical Equipment & Medical Supplies in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2012; 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.