George Philip Kelly, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

16015 Issued in CT

Practice address

10 Mott Ave
Norwalk, CT 06850-3320

Phone

(203) 854-6915

Fax

(203) 854-6987

NPI assigned

Aug 20, 2007

Last updated

Aug 20, 2007By the provider in NPPES

Sex

Male

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 1, 2023 through Apr 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1187568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187568000000",
    "number": "1417140815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 SKY TOP DR",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068251216",
            "telephone_number": "203-374-3483",
            "fax_number": "203-371-0249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MOTT AVE",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068503320",
            "telephone_number": "203-854-6915",
            "fax_number": "203-854-6987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "GEORGE",
        "middle_name": "PHILIP",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-20",
        "last_updated": "2007-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "16015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa A Kelleher, LCSW
• Chana Judith Kelley, APRN
• Aidan Kelly
• David E Kelly, LCSW
• Eileen Patrice Kelly, L.M.F.T.
• Paul R Kelly, D.O.
• Cristina Kempf, RDH
• Byron S Kennedy, MD, PHD, MPH
• Karyn Kennedy, BCBA
• Sage Ann Kenny, PA-C

• Psychiatry Physician in Norwalk, CT
• Providers in Norwalk, CT by specialty
• Psychiatry Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.