Active NPI
Judy Kelly, D.C.
- Chiropractor
- Carrollton, TX
National Provider Identifier
1366616211
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 5277
- Practice address
- 1925 E Belt Line Rd
#503
Carrollton, TX 75006-5801 - Phone
- (972) 242-3080
- Fax
- (972) 242-2071
- NPI assigned
- Apr 22, 2008
- Last updated
- Aug 13, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 5277 | TX | Primary |
Addresses
Primary practice location
1925 E Belt Line Rd
#503
Carrollton, TX 75006-5801
Mailing address
1925 E Belt Line Rd
#503
Carrollton, TX 75006-5801
Phone (972) 242-3080
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Life Chiropractic College, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1925 E Belt Line Rd
Suite 328
Carrollton, TX 75006-5931
Phone (972) 242-3080
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5277 | TX | MD | Chiropractor |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208822400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344816000000",
"number": "1366616211",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1925 E BELT LINE RD",
"address_2": "#503",
"city": "CARROLLTON",
"state": "TX",
"postal_code": "750065801",
"telephone_number": "972-242-3080",
"fax_number": "972-242-2071"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1925 E BELT LINE RD",
"address_2": "#503",
"city": "CARROLLTON",
"state": "TX",
"postal_code": "750065801",
"telephone_number": "972-242-3080",
"fax_number": "972-242-2071"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "JUDY",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-04-22",
"last_updated": "2012-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "TX",
"license": "5277",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Carrollton, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.