Crystal Denise Kelly, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

N3785 Issued in TX

Practice address

17500 W Grand Pkwy S
Memorial Hermann- Sound Physicians
Sugar Land, TX 77479-2562

Phone

(281) 725-5070

Fax

(281) 725-5089

NPI assigned

Sep 8, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Zion Behavioral Health Services Inc

  • Internal Medicine Physician
  • South Holland, IL
  • NPI 1467474395
  NPD (past)

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

{
    "created_epoch": "1126137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282176000000",
    "number": "1538153283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17500 W GRAND PKWY S",
            "address_2": "MEMORIAL HERMANN- SOUND PHYSICIANS",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774792562",
            "telephone_number": "281-725-5070",
            "fax_number": "281-725-5089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17500 W GRAND PKWY S",
            "address_2": "MEMORIAL HERMANN- SOUND PHYSICIANS",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774792562",
            "telephone_number": "281-725-5070",
            "fax_number": "281-725-5089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "CRYSTAL",
        "middle_name": "DENISE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-08",
        "last_updated": "2010-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036099345",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01055817A",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "N3785",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "N3785",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200273460",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Manasi S. Kekan, M.D.
• Amberlyn Keller, M.ED, LPC
• Vierra Keller
• John P. Kelley, MD
• Kellmarc Home Health Therapis
• Grace Nicole Kelly
• Hannah Elizabeth Kelly, PA-C
• Mabel Kokonne Kelly, CCC-SLP
• Scott Andrew Kelly, D.C.
• Kenneth R Kemp Jr., MD

• Internal Medicine Physician in Sugar Land, TX
• Providers in Sugar Land, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2010; 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.