Charles E Kelly II MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

CHARLES E KELLY II MD

Practice address

2835 Hwy 231 N
Suite 208a
Shelbyville, TN 37160-7327

Phone

(931) 231-0559

NPI assigned

Aug 25, 2008

Last updated

Aug 25, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Charles E Kelly II, MDNPI 1780678979

Title

Owner

Phone

(931) 629-9993

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Charles E Kelly II, MD

  • Gastroenterology Physician
  • Shelbyville, TN
  • NPI 1780678979
  NPD (past) Authorized official

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

{
    "created_epoch": "1219622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219622400000",
    "number": "1457508160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2835 HWY 231 N",
            "address_2": "SUITE 208A",
            "city": "SHELBYVILLE",
            "state": "TN",
            "postal_code": "371607327",
            "telephone_number": "931-231-0559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2835 HWY 231 N",
            "address_2": "SUITE 208A",
            "city": "SHELBYVILLE",
            "state": "TN",
            "postal_code": "371607327",
            "telephone_number": "931-231-0559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES E KELLY II MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-25",
        "last_updated": "2008-08-25",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "931-629-9993",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gastroenterology Physician in Shelbyville, TN
• Providers in Shelbyville, TN by specialty
• Gastroenterology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2008; 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.