Active NPI
Bradley Kelly
- Clinical Social Worker
- Manhattan, KS
National Provider Identifier
1467142661
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 12957
- Practice address
- 2308 Browning Ave
Manhattan, KS 66502-1934 - Phone
- (785) 384-8714
- Fax
- (785) 414-5410
- NPI assigned
- May 10, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 12957 | KS | Primary |
Addresses
Primary practice location
2308 Browning Ave
Manhattan, KS 66502-1934
Mailing address
2308 Browning Ave
Manhattan, KS 66502-1934
Phone (785) 384-8714
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12957 | KS | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1683676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1683676800000",
"number": "1467142661",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2308 BROWNING AVE",
"city": "MANHATTAN",
"state": "KS",
"postal_code": "665021934",
"telephone_number": "785-384-8714",
"fax_number": "785-414-5410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2308 BROWNING AVE",
"city": "MANHATTAN",
"state": "KS",
"postal_code": "665021934",
"telephone_number": "785-384-8714",
"fax_number": "785-414-5410"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "BRADLEY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-05-10",
"last_updated": "2023-05-10",
"certification_date": "2023-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "KS",
"license": "12957",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manhattan, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.