NPIMap

Organization Active NPI

Kellam & Associates, P. C.

  • Diagnostic Radiology Physician
  • Lapeer, MI
National Provider Identifier
1366472029
Registry record updated Feb 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
KELLAM & ASSOCIATES, P. C.
Practice address
1375 N Main St
Lapeer, MI 48446-1350
Phone
(810) 667-5500
NPI assigned
Jul 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2013

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

Authorized official

Name
Kenneth TarrNPI 1902834070
Title
President
Phone
(810) 667-5744

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085R0202X Primary
Vascular & Interventional Radiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085R0204X
Magnetic Resonance Imaging (MRI) Clinic/Center 261QM1200X
Radiology Clinic/Center 261QR0200X

Addresses

Primary practice location

1375 N Main St
Lapeer, MI 48446-1350

Mailing address

PO Box 32627
Detroit, MI 48232-0627
Phone (866) 744-1452

Other identifiers 2

IdentifierTypeStateIssuer
300F361250OtherMIBCBS GROUP #
CA3518OtherMIRR GROUP PIN

National Provider Directory

National Provider Directory

Locations

7619 Solutions Ctr
Chicago, IL 60677

937 N Opdyke Rd
Auburn Hills, MI 48326
Phone (248) 373-7600

5625 Water Tower Pl
Ste G3
Clarkston, MI 48346
Phone (248) 922-2800

5701 Bow Pointe Dr
Ste 255
Clarkston, MI 48346
Phone (248) 922-6810

801 Joe Mann Blvd
Ste B
Midland, MI 48642
Phone (989) 794-4020

805 Oakwood Dr
Ste 112
Rochester Hills, MI 48307
Phone (248) 413-6150

301 N Main St
#279
Sheridan, MI 48884
Phone (989) 291-3261

Practitioners & affiliated clinicians

Practitioners 29

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360108800000",
    "number": "1366472029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 32627",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482320627",
            "telephone_number": "866-744-1452",
            "fax_number": "586-412-4101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1375 N MAIN ST",
            "city": "LAPEER",
            "state": "MI",
            "postal_code": "484461350",
            "telephone_number": "810-667-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLAM & ASSOCIATES, P. C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2013-02-06",
        "status": "A",
        "authorized_official_last_name": "TARR",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "810-667-5744"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP #",
            "identifier": "300F361250",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR GROUP PIN",
            "identifier": "CA3518",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lapeer, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2013; 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.