Courtney Parker Kelly

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6533 Issued in AL

Practice address

100 57TH St S
Birmingham, AL 35212-2541

Phone

(205) 591-1101

NPI assigned

Sep 20, 2018

Last updated

Sep 20, 2018By the provider in NPPES

Sex

Female

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

Practice roles

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.

• Benjamin D. Williams DMD PA

  dba Woodlawn Dental

  • Dentist
  • Birmingham, AL
  • NPI 1265603823

  General Practice

  NPD (past)

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

{
    "created_epoch": "1537401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537401600000",
    "number": "1407330913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 DUNSTON AVE",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352131601",
            "telephone_number": "251-401-6686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 57TH ST S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352122541",
            "telephone_number": "205-591-1101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "COURTNEY",
        "middle_name": "PARKER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-20",
        "last_updated": "2018-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "6533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tonisha Mechelle Kelley, FNP-C
• Weddington Bishop Kelley, MD
• Amanda Weathers Kelly, M.S.,CCC-SLP
• Arthur G Kelly, MD
• Christopher L Kelly, M.D.
• David R Kelly, MD
• Elisabeth Nancy Kelly, RBT
• Emily Ann Kelly, LPC
• James Bernard Kelly, MD
• Kameron Kelly

• General Practice Dentistry in Birmingham, AL
• Providers in Birmingham, AL by specialty
• General Practice Dentistry in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2018; 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.