Lawrence Kelly, MD PC

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

35083 Issued in AZ

Legal business name

LAWRENCE KELLY, MD PC

Practice address

12361 W Bola Dr
Surprise, AZ 85378-9021

Phone

(623) 853-4812

Fax

(623) 584-8998

NPI assigned

Jul 12, 2013

Organization subpart

No

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

Authorized official

Name

Lawrence J Kelly, MDNPI 1124014758

Title

Physician

Phone

(623) 583-2073

Specialties & licenses 1

Addresses

Practitioners 1

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

• Lawrence J Kelly, MD

  • Orthopaedic Surgery Physician
  • Surprise, AZ
  • NPI 1124014758

  Sports Medicine

  NPD (past) Authorized official

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

{
    "created_epoch": "1373587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373587200000",
    "number": "1457792962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1149",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853801149",
            "telephone_number": "623-583-2073",
            "fax_number": "623-583-1099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12361 W BOLA DR",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853789021",
            "telephone_number": "623-853-4812",
            "fax_number": "623-584-8998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAWRENCE KELLY, MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-12",
        "last_updated": "2013-07-12",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "623-583-2073",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "AZ",
            "license": "35083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sports Medicine (Orthopaedic Surgery) Physician in Surprise, AZ
• Providers in Surprise, AZ by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2013; 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.