NPIMap

Organization Active NPI

Kellco Medical Equipment

  • Durable Medical Equipment & Medical Supplies
  • Rome, GA
National Provider Identifier
1417419904
Registry record updated Apr 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
KELLCO MEDICAL EQUIPMENT
Practice address
1903 Turner McCall Blvd SE
Rome, GA 30161-3366
Phone
(706) 237-7223
NPI assigned
Apr 3, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2019

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

Authorized official

Name
Mr. Timothy L KelleyNPI 1134681059
Title
Owner/Ceo
Phone
(706) 237-7223

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

1903 Turner McCall Blvd SE
Rome, GA 30161-3366

Mailing address

1903 Turner McCall Blvd SE
Rome, GA 30161-3366
Phone (706) 237-7223

Other identifiers 1

IdentifierTypeStateIssuer
054860421OtherGASTATE OF GEORGIA

Electronic endpoints 3

TypeEndpointUseAffiliation
Other URL NPPES.CMS.HHS.GOV Direct
CONNECT URL EFI Direct
Other URL URL Direct

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1554249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554249600000",
    "number": "1417419904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1903 TURNER MCCALL BLVD SE",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301613366",
            "telephone_number": "706-237-7223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1903 TURNER MCCALL BLVD SE",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301613366",
            "telephone_number": "706-237-7223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLCO MEDICAL EQUIPMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-03",
        "last_updated": "2019-04-03",
        "status": "A",
        "authorized_official_last_name": "KELLEY",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "706-237-7223",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF GEORGIA",
            "identifier": "054860421",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "NPPES.CMS.HHS.GOV",
            "affiliation": "N",
            "endpointDescription": "NPI REGISTRY",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1903 Turner McCall Blvd SE",
            "city": "Rome",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301613366",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "EFI",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1903 Turner McCall Blvd SE",
            "city": "Rome",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301613366",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "URL",
            "affiliation": "N",
            "endpointDescription": "URL",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1903 Turner McCall Blvd SE",
            "city": "Rome",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301613366",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rome, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2019; 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.