Darnell V Kellam Jr.

Primary specialty

DriverTaxonomy code 172A00000X

License

Y4692667 Issued in CA

Practice address

3410 Mission Ave Apt 35
Carmichael, CA 95608-3161

Phone

(678) 457-1598

NPI assigned

Jul 26, 2019

Last updated

Jul 26, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1564099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564099200000",
    "number": "1356995492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3410 MISSION AVE APT 35",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956083161",
            "telephone_number": "678-457-1598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3410 MISSION AVE APT 35",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956083161",
            "telephone_number": "678-457-1598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLAM",
        "first_name": "DARNELL",
        "middle_name": "V",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-26",
        "last_updated": "2019-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Driver",
            "state": "CA",
            "license": "Y4692667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• KCL Quality Care
• Caitlyn Keane
• Carole Kearns, L.V.N.
• Heather Dawn Keehn, ASW
• Keith Hardoin, Professional Chiropractic Corp.
• Gregory David Kelly
• Dianne Kendall
• Rose Marie Kennard
• Ranny Keopradabsy
• Daniel Joseph Ketchum, RPH

• Driver in Carmichael, CA
• Providers in Carmichael, CA by specialty
• Driver in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2019; 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.