John Edward Kelly MD PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

D0006349 Issued in MD

Legal business name

JOHN EDWARD KELLY MD PA

Practice address

2401 Research Blvd Ste 340
Rockville, MD 20850-6254

Phone

(301) 212-9200

NPI assigned

Nov 17, 2010

Organization subpart

No

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

Authorized official

Name

Dr. John Edward Kelly, MD

Title

President

Phone

(301) 212-9200

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• JOHN EDWARD KELLY MD PA Other name

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/12774/brand/1/csg/1/fhir/r4

Practitioners 1

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

• Teresa L Hoang, MD

  • Family Medicine Physician
  • Rockville, MD
  • NPI 1295920650

  DC

  Medicare reassignment

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

{
    "created_epoch": "1289952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292371200000",
    "number": "1407158850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 RESEARCH BLVD STE 340",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208506254",
            "telephone_number": "301-212-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 RESEARCH BLVD STE 340",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208506254",
            "telephone_number": "301-212-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN EDWARD KELLY MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-17",
        "last_updated": "2010-12-15",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-212-9200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0006349",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113251200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JOHN EDWARD KELLY MD PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Brynn McKenna Jobson
• Jocelyn Shuler LLC
• Brian Joe Jr
• Christina Johannessen, FNP
• John D Paulson MD PC
• John J. O'Connor MD PC
• John L. Gildner Regional Institute for Children and Adolescents
• John S Eng MD PA
• John S. Saia, MD, Facp
• Anthony John

• Family Medicine Physician in Rockville, MD
• Providers in Rockville, MD by specialty
• Family Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.