Organization Active NPI

Kelley Chiropractic

  • Chiropractor
  • Roseville, CA
National Provider Identifier
1508034000
Registry record updated Feb 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
KELLEY CHIROPRACTIC
Practice address
151 N Sunrise Ave
Suite 907
Roseville, CA 95661-2924
Phone
(916) 786-5828
Fax
(916) 786-5055
NPI assigned
Feb 19, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2008

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

Authorized official

Name
Dr. Gary C Kelley, D.C.NPI 1174522635
Title
Dr.
Phone
(916) 786-5828

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

151 N Sunrise Ave
Suite 907
Roseville, CA 95661-2924

Mailing address

151 N Sunrise Ave
Suite 907
Roseville, CA 95661-2924
Phone (916) 786-5828

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031106000459 CA Part B Supplier - Clinic/Group Practice 4486567401 Receives reassigned benefits from 2 practitioners
Practice locations: Roseville, CA

National Provider Directory

National Provider Directory

Locations

151 N Sunrise Ave
Ste 701
Roseville, CA 95661
Phone (916) 782-4440

151 N Sunrise Ave
Roseville, CA 95661
Phone (916) 720-2067

151 N Sunrise Ave
Ste 907
Roseville, CA 95661
Phone (916) 786-5828

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1203379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203379200000",
    "number": "1508034000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 N SUNRISE AVE",
            "address_2": "SUITE 907",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612924",
            "telephone_number": "916-786-5828",
            "fax_number": "916-786-5055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 N SUNRISE AVE",
            "address_2": "SUITE 907",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612924",
            "telephone_number": "916-786-5828",
            "fax_number": "916-786-5055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLEY CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-19",
        "last_updated": "2008-02-19",
        "status": "A",
        "authorized_official_last_name": "KELLEY",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DR.",
        "authorized_official_telephone_number": "916-786-5828",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; 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.