Individual provider Active NPI

Cecilia Kelly

  • Neurology Physician
  • Rochester, MN
National Provider Identifier
1497134464
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
2021-02645 Issued in NC
Practice address
200 1St St SW
Rochester, MN 55905-0001
Phone
(507) 284-2511
NPI assigned
May 24, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 2021-02645 NC Primary
Neurology Physician 2084N0400X 60792 MN

Addresses

Primary practice location

200 1St St SW
Rochester, MN 55905-0001

Mailing address

5213 S Alston Ave
Durham, NC 27713-4430
Phone (919) 620-4855

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211209002693 NC Practitioner - Neurology 8921319112 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Emory University School of Medicine, 2015
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Comprehensive Rehab of Wilson, Inc.Group PAC ID 2668377375, 115 clinicians
Duke Health Integrated Practice IncGroup PAC ID 8325412737, 3,140 clinicians

Practice addresses (Care Compare)

1811 Forest Hills Rd W
Wilson, NC 27893-3412
Phone (252) 243-7400

3480 Wake Forest Rd
Raleigh, NC 27609-7376
Phone (919) 684-8111

40 Duke Medicine Cir
Durham, NC 27710-4000
Phone (919) 684-8111

Hospital & facility affiliations

  • Duke Regional Hospital Hospital, Durham, NC, CCN 340155
  • Duke University Hospital Hospital, Durham, NC, CCN 340030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
60792MNMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Duke Health Integrated Practice, Inc. CurrentSince Jul 1, 2023 Accepting new patients

Locations

40 Duke Medicine Cir
Durham, NC 27710
Phone (919) 681-6588

3480 Wake Forest Rd
Raleigh, NC 27609
Phone (919) 862-5075

3480 Wake Forest Rd
Ste 310
Raleigh, NC 27609
Phone (919) 862-5620

Interoperability endpoints

  • Direct secure messaging: ckelly506985@direct.medicine.duke.edu

Organizations & group practices 2

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1432425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1497134464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5213 S ALSTON AVE",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277134430",
            "telephone_number": "919-620-4855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "CECILIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-24",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NC",
            "license": "2021-02645",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MN",
            "license": "60792",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

Verify at the official NPI Registry.