Individual provider Active NPI

David K. Kelley, MD

  • Internal Medicine Physician
  • Harrisburg, PA
National Provider Identifier
1356457972
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD037995-E Issued in PA
Practice address
409 S 2ND St
Suite 3F
Harrisburg, PA 17104-1612
Phone
(717) 230-3459
Fax
(717) 230-3411
NPI assigned
Aug 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD037995-E PA Primary

Addresses

Primary practice location

409 S 2ND St
Suite 3F
Harrisburg, PA 17104-1612

Mailing address

2645 N 3Rd St
Community Health Ctr. 4TH FL
Harrisburg, PA 17110-2001
Phone (717) 782-6421

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD037995-EPAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1356457972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2645 N 3RD ST",
            "address_2": "COMMUNITY HEALTH CTR. 4TH FL",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171102001",
            "telephone_number": "717-782-6421",
            "fax_number": "717-782-6410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 S 2ND ST",
            "address_2": "SUITE 3F",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171041612",
            "telephone_number": "717-230-3459",
            "fax_number": "717-230-3411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "DAVID",
        "middle_name": "K.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD037995-E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.