Jordan Kelley, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT1270 Issued in KY

Practice address

195 Academic Athletic Center
Morehead, KY 40351

Phone

(606) 783-2392

NPI assigned

Nov 18, 2016

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1479427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479427200000",
    "number": "1417490764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 ACADEMIC ATHLETIC CENTER",
            "city": "MOREHEAD",
            "state": "KY",
            "postal_code": "40351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 ACADEMIC ATHLETIC CENTER",
            "city": "MOREHEAD",
            "state": "KY",
            "postal_code": "40351",
            "telephone_number": "606-783-2392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "JORDAN",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-11-18",
        "last_updated": "2016-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "KY",
            "license": "AT1270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kitrina Lou Kearfott, M.D.
• Melinda Keeton
• Melissa Keeys
• Derek Allan Keller, DO
• Jeremy Steven Keller, D.O.
• Marc Kelly, LCSW
• Sherrie Lee Keltner, PMHNP-BC
• Kenneth J Smith DDS PSC
• Kenney Orthopedics of Morehead, LLC
• Kentucky Eye Institute for Eye Health & Surgery

• Athletic Trainer in Morehead, KY
• Providers in Morehead, KY by specialty
• Athletic Trainer in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2016; 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.