Kelly Chiropractic Center, PA

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2714 Issued in NC

Legal business name

KELLY CHIROPRACTIC CENTER, PA

Practice address

1825 16TH St SW
Minot, ND 58701-6428

Phone

(701) 838-5000

Fax

(701) 852-1184

NPI assigned

Sep 14, 2006

Last updated

Sep 17, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Chad Garrett Kelly, D.C.NPI 1245247626

Title

Chiropractor/Owner

Phone

(910) 214-6887

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Chad Garrett Kelly, D.C.

  • Chiropractor
  • Minot, ND
  • NPI 1245247626
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568678400000",
    "number": "1356446926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1483",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587021483",
            "telephone_number": "701-838-5000",
            "fax_number": "701-852-1184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 16TH ST SW",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587016428",
            "telephone_number": "701-838-5000",
            "fax_number": "701-852-1184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY CHIROPRACTIC CENTER, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2019-09-17",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "GARRETT",
        "authorized_official_title_or_position": "CHIROPRACTOR/OWNER",
        "authorized_official_telephone_number": "910-214-6887",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "2714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890841K",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christine Lynn Keller, RN
• Taylor Keller, LPCC
• Heather England Kelley, M.A., PSYD.
• Madison Kellogg
• Kelsey Lynn Kellow, MS, CCC-SLP
• Kelly Chiropractic, PA
• Kelly Chiropractic, PC
• Kelly Drevecky (Prairie Therapy)
• Chad Garrett Kelly, D.C.
• Karen J Kelly, CRNA

• Chiropractor in Minot, ND
• Providers in Minot, ND by specialty
• Chiropractor in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.