James Brian Kelly, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

3936 Issued in GA

Practice address

175 White St NW Ste 200
Marietta, GA 30060-7901

Phone

(404) 255-1933

Fax

(404) 256-7924

NPI assigned

Feb 24, 2006

Last updated

Jun 6, 2022By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Children's Orthopaedics of Atlanta P.C.

  • Orthopaedic Surgery Physician
  • Atlanta, GA
  • NPI 1548247000
  NPD (past)
• Choa Hospital Based, LLC

  • Pediatrics Physician
  • Brookhaven, GA
  • NPI 1457695488
  NPD (past)
• Thomas J McElligott MD PC

  dba East Metro Orthopaedics

  • Orthopaedic Surgery Physician
  • Conyers, GA
  • NPI 1003002767
  NPD (past)
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  NPD (past)

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1558337055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 WHITE ST NW STE 200",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300607901",
            "telephone_number": "404-255-1933",
            "fax_number": "404-256-7924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 WHITE ST NW STE 200",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300607901",
            "telephone_number": "404-255-1933",
            "fax_number": "404-256-7924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JAMES",
        "middle_name": "BRIAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-24",
        "last_updated": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "3936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "choa@choa.gadirect.net",
            "affiliation": "N",
            "address_1": "175 White St NW Ste 200",
            "city": "Marietta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300607901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Terry Vern Kelley, M.D.
• Jennifer Gladney Kellner, NP-C
• Kira Kellogg, MSW, LMSW
• Dianne Flint Kelly, MS
• Holli Maria Kelly, LMFT
• Jennifer Ann Kelly
• Onika Kelly, MD
• Raelynn Marie Kelly
• Gunjan Kelotra-Jindia, MD
• Caroline Elyse Kemp, PA

• Medical Physician Assistant in Marietta, GA
• Providers in Marietta, GA by specialty
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2022; 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.