Kevin James Kelly, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD037735E Issued in PA

Practice address

805 Sir Thomas CT FL 2
Harrisburg, PA 17109-4839

Phone

(717) 657-3030

Fax

(717) 671-0991

NPI assigned

Mar 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA

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.

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 and National Provider Directory roles.

• Pinnacle Health Medical Services

  • Family Medicine Physician
  • Harrisburg, PA
  • NPI 1932143427
  Medicare reassignment NPD
• Pinnacle Health Medical Services

  dba UPMC Gastroenterology Associates of Central PA

  • Gastroenterology Physician
  • Mechanicsburg, PA
  • NPI 1295552073
  NPD
• Pinnacle Health Medical Services

  dba UPMC CAC Behavioral Health

  • Professional Counselor
  • Harrisburg, PA
  • NPI 1861069791
  NPD
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1437119401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 SIR THOMAS CT FL 2",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171094839",
            "telephone_number": "717-657-3030",
            "fax_number": "717-671-0991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 SIR THOMAS CT FL 2",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171094839",
            "telephone_number": "717-657-3030",
            "fax_number": "717-671-0991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "KEVIN",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD037735E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007100474",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kkelly7686@phsdirect.pinnaclehealth.org",
            "affiliation": "N",
            "address_1": "805 Sir Thomas Ct Fl 2",
            "city": "Harrisburg",
            "state": "PA",
            "country_code": "US",
            "postal_code": "171094839",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Suzanne Kay Kelley, DO
• Jasmine Kelliehan
• Dana Sterling Kellis, MD
• Briana C Kelly, BA
• Emily Kelly, DO
• Kim H Kelly, CRNA
• Sarah Beth Kelly, LPC
• Tara Kelly
• Veronica Kelly
• Kena Care Home Health Agency LLC

• Family Medicine Physician in Harrisburg, PA
• Providers in Harrisburg, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; 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.