William T Kelley, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD022885E Issued in PA

Practice address

1000 East 2ND Street
Coudersport, PA 16915

Phone

(814) 274-9300

NPI assigned

Jan 25, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Md4Er LLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Key West, FL
  • NPI 1568851707

  FL

  Medicare reassignment NPD
• Key Vaca Emergency Physicians LLC

  • Emergency Medicine Physician
  • Marathon, FL
  • NPI 1770892002

  Emergency Medicine

  NPD (past)

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1508911736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 S PALAFOX ST",
            "address_2": "SUITE 300",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325025937",
            "telephone_number": "800-444-7009",
            "fax_number": "800-305-3233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 EAST 2ND STREET",
            "city": "COUDERSPORT",
            "state": "PA",
            "postal_code": "16915",
            "telephone_number": "814-274-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "WILLIAM",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD022885E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Noah Jordan
• Kathleen a. Rokavec MD
• Andrew James Kayes, M.D.
• Rebecca Keagle
• William P Kehr, LCSW
• Kathleen M Kerr, PA
• Keystone Rural Health Consortia, Inc.
• Ekta Khanna, M.D.
• Craig Kinney, PTA
• Dennis Albert Larkin Jr., PTA

• All providers in Coudersport, PA
• Emergency Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.