Holly C Kelly MD Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

License

A72149 Issued in CA

Legal business name

HOLLY C KELLY MD INC.

Practice address

7100 Redwood Blvd
Suite 200
Novato, CA 94945-4110

Phone

(415) 492-1600

Fax

(415) 492-1688

NPI assigned

Oct 17, 2007

Last updated

Feb 7, 2012By 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

Dr. Holly C Kelly, MD

Title

Physician

Phone

(415) 492-1600

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1192579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328572800000",
    "number": "1487843207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7100 REDWOOD BLVD",
            "address_2": "SUITE 200",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949454110",
            "telephone_number": "415-492-1600",
            "fax_number": "415-492-1688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7100 REDWOOD BLVD",
            "address_2": "SUITE 200",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949454110",
            "telephone_number": "415-492-1600",
            "fax_number": "415-492-1688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLY C KELLY MD INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-17",
        "last_updated": "2012-02-07",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "415-492-1600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A72149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SINGLE NPI NUMBER",
            "identifier": "1619076528",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dawn Cheree Holiday-Bruner, MFT
• Elise Holland
• Brian Neal Hollander, DDS MS
• Susan Carol Hollander, N.P.
• Jessica Catherine Hollman, M.D.
• Kevin Jude Holman, PA-C
• Donnell M Holmes, MFT
• Sara Mathew Holmes, MD
• Homewatch Caregivers of the North Bay
• Honeycomb Wellness Center LLC

• Specialist in Novato, CA
• Providers in Novato, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2012; 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.