Kelley Davis, D.O., P.a.

Primary specialty

SpecialistTaxonomy code 174400000X

License

L8319 Issued in TX

Legal business name

KELLEY DAVIS, D.O., P.A.

Practice address

1251A E Red Bird LN
Dallas, TX 75241-2008

Phone

(214) 307-0827

Fax

(214) 307-0927

NPI assigned

Jun 24, 2006

Organization subpart

No

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

Authorized official

Name

Kelley Michelle Davis, D.ONPI 1609833771

Title

President

Phone

(214) 374-0827

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Kelley Michelle Davis, D.O.

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1609833771
  NPD (past) Authorized official

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196380800000",
    "number": "1477589059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1251A E RED BIRD LN",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752412008",
            "telephone_number": "214-307-0827",
            "fax_number": "214-307-0927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1251A E RED BIRD LN",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752412008",
            "telephone_number": "214-307-0827",
            "fax_number": "214-307-0927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLEY DAVIS, D.O., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-24",
        "last_updated": "2007-11-30",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "KELLEY",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "214-374-0827",
        "authorized_official_credential": "D.O"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": "L8319",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11568320",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristine Keller
• Mary Jane Keller, LPC
• Molly Keller
• Sarah Keller, MCN, RD, LD, CNSC
• Zachary Keller, P.T.
• Terri Ann Kelley-Griffis, FNP-C
• Whitney L Kelley-Mahana, CRNA
• Anastasia Natalia Kelley
• Ashley Kelley, DC
• Audrey Kelley, MD

• Specialist in Dallas, TX
• Providers in Dallas, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2007; 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.