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
- 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
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 088403301 | Medicaid | TX |
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 and National Provider Directory roles.
-
- Chiropractor
- Carrollton, TX
- NPI 1770566762
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": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "088403301",
"state": "TX"
}
],
"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.