Kell Medical PA

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

KELL MEDICAL PA

Practice address

200 Doctors Dr Ste F
Jacksonville, NC 28546-6308

Phone

(910) 353-1499

Fax

(910) 355-0404

NPI assigned

Jun 18, 2008

Organization subpart

No

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

Authorized official

Name

Robert E Kell, M.D.NPI 1710086236

Title

Primary Doctor

Phone

(910) 353-1499

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 3

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

• Robert E Kell, M.D

  • Primary Care Clinic/Center
  • Jacksonville, NC
  • NPI 1710086236

  General Practice

  Medicare reassignment Care Compare group NPD Authorized official
• Victoria L Kell, CNP

  • Primary Care Nurse Practitioner
  • Jacksonville, NC
  • NPI 1386856649
  Medicare reassignment Care Compare group NPD
• Kaylea Goodson, FNP-BC

  • Family Nurse Practitioner
  • Jacksonville, NC
  • NPI 1063268340
  NPD

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

{
    "created_epoch": "1213747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668643200000",
    "number": "1508027046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 DOCTORS DR STE F",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466308",
            "telephone_number": "910-353-1499",
            "fax_number": "910-355-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 DOCTORS DR STE F",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466308",
            "telephone_number": "910-353-1499",
            "fax_number": "910-355-0404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELL MEDICAL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-18",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A",
        "authorized_official_last_name": "KELL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRIMARY DOCTOR",
        "authorized_official_telephone_number": "910-353-1499",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NC",
            "license": "9600132",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "48308",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Kell.Robert.002.0330068@KEME.meditab.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Kell Medical PA",
            "address_1": "200 Doctors Dr Ste F",
            "city": "Jacksonville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "285466308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Keefer Chiropractic Center, a Professional Corporation
• Sean Michael Keefer, D.C.
• Tracy Ann Keefer, D.C.
• Loretta Busby Keelin, LCSW
• Genna Lynn Kelkenberg, PHARMD
• Robert E Kell, M.D
• Victoria L Kell, CNP
• Kathryn Ann Kelley, LCMHC
• Sarah E Kelley, LCSW
• Harold Field Kellogg III, LCSW

• General Practice Physician in Jacksonville, NC
• Providers in Jacksonville, NC by specialty
• General Practice Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.