Burnett S Kelly, MD

Primary specialty

Transplant Surgery PhysicianTaxonomy code 204F00000X

License

40226 Issued in TN

Practice address

1313 21St Ave S
Oxford House Suite 801
Nashville, TN 37232-0001

Phone

(615) 936-3427

Fax

(615) 936-0435

NPI assigned

Jul 11, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sutter Bay Medical Foundation

  dba Palo Alto Medial Foundation

  • Multi-Specialty Clinic/Center
  • Palo Alto, CA
  • NPI 1013950807
  Medicare reassignment NPD
• Sutter Bay Medical Foundation

  dba Sutter Pacific Medical Foundation

  • Multi-Specialty Clinic/Center
  • Sacramento, CA
  • NPI 1003267196
  NPD
• Sutter Bay Medical Foundation

  dba Palo Alto Medical Foundation

  • Clinical Medical Laboratory
  • Santa Clara, CA
  • NPI 1669287033
  NPD

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427083211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6104 ROBIN HILL RD",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372053230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 21ST AVE S",
            "address_2": "OXFORD HOUSE SUITE 801",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372320001",
            "telephone_number": "615-936-3427",
            "fax_number": "615-936-0435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "BURNETT",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204F00000X",
            "taxonomy_group": "",
            "desc": "Transplant Surgery",
            "state": "CA",
            "license": "A83773",
            "primary": false
        },
        {
            "code": "204F00000X",
            "taxonomy_group": "",
            "desc": "Transplant Surgery",
            "state": "TN",
            "license": "40226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "00A837730",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "40226",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan Allen Kelln, D.O.
• Kathryn Murray Kellogg, M.D., M.P.H.
• Colleen Kelly-Teiken
• Alexys Kelly, DDS
• Bridget Kelly, B.C.B.A.
• Casey Marie Kelly, RN
• Cecilia Jacqueline Kelly, NP
• Christy Kelly, RN
• Connor Kelly, MD
• Ellen M. Kelly, PHD

• Transplant Surgery Physician in Nashville, TN
• Providers in Nashville, TN by specialty
• Transplant Surgery Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.