Robert Francis Kelly, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2020042060 Issued in MO

Practice address

633 Emerson Rd Ste 20
Creve Coeur, MO 63141-6739

Phone

(314) 325-3068

NPI assigned

May 24, 2019

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Barnabas Health Medical Group PC

  • Specialist
  • Elizabeth, NJ
  • NPI 1841557246
  NPD (past)

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

{
    "created_epoch": "1558656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632096000000",
    "number": "1457918450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 EMERSON RD STE 20",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631416739",
            "telephone_number": "314-325-3068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 EMERSON RD STE 20",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631416739",
            "telephone_number": "314-325-3068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "ROBERT",
        "middle_name": "FRANCIS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-24",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2020042060",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00522100",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karla Keaney, M.D.
• Abbe Michelle Keen, D.C.
• Dennis J Keithly, MD
• Breanna Lynn Keller, MSCCC-SLP
• Allison Kelley, OTR/L
• Nancy Ketring Kennedy, O.D.
• Saad Z Khan, M.D.
• Sunna Khan, MD
• Aisha Khorana, M.ED., PLPC
• Johnny Kim, LCSW

• Physician Assistant in Creve Coeur, MO
• Providers in Creve Coeur, MO by specialty
• Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2021; 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.