Brian Ismael Kelly, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95184031 Issued in CA

Practice address

525 W Acacia St
Stockton, CA 95203-2405

Phone

(209) 944-5550

NPI assigned

May 27, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

University of South Alabama College of Medicine, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Trinity Emergency PhysiciansGroup PAC ID 4284171166, 47 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Trinity Emergency Physicians

  • Emergency Medicine Physician
  • Redding, CA
  • NPI 1508605635
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1748304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753488000000",
    "number": "1407649957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6701 SHOREWOOD LN",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952197004",
            "telephone_number": "925-300-5917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 W ACACIA ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952032405",
            "telephone_number": "209-944-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "BRIAN",
        "middle_name": "ISMAEL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-27",
        "last_updated": "2025-07-26",
        "certification_date": "2025-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "CA",
            "license": "95184031",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95184031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brett Keleher
• Jeff Kellar
• Citrus Lamar Phillip Kelley
• Madeline Ali Kelley
• Shakeia Monique Kelley
• Shawna Kelly
• Tracy Juneil Kelly
• Carrisa Kemp
• Sydney T Kemp
• Alison Kemps, LCSW

• Nurse Practitioner in Stockton, CA
• Providers in Stockton, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.

Verify at the official NPI Registry.