Jonna M Kelly, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA10004532 Issued in WA

Practice address

2930 Squalicum Pkwy
101
Bellingham, WA 98225-1854

Phone

(360) 988-9008

Fax

(360) 594-4012

NPI assigned

Sep 25, 2006

Sex

Female

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.

• Waikiki Health

  • Federally Qualified Health Center (FQHC)
  • Honolulu, HI
  • NPI 1528359791
  NPD (past)

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494460800000",
    "number": "1497856314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21718 STERLING DR",
            "city": "SEDRO WOOLLEY",
            "state": "WA",
            "postal_code": "982848761",
            "telephone_number": "360-707-1164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2930 SQUALICUM PKWY",
            "address_2": "101",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982251854",
            "telephone_number": "360-988-9008",
            "fax_number": "360-594-4012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JONNA",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2017-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10004532",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "HI",
            "license": "AMD-431",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mara Wells Kelley, MD
• Mary-Ann Ruth Kelley, CDP
• Betty J. Kellow
• Kelly Lunda Physical Therapy P.S.
• Cameron E Kelly, MHCA
• Kalin Kelly, LMT
• Richard Kelly, MD
• Kelsey Karolyn Counseling PLLC
• Maureen Kelty, MD PC
• Ashley Kemp

• Physician Assistant in Bellingham, WA
• Providers in Bellingham, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2017; 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.