Walter E. Kelley, DO

Primary specialty

Clinical Pathology PhysicianTaxonomy code 207ZC0006X

License

9347417-1204 Issued in UT

Practice address

6616 S 900 E
Salt Lake City, UT 84121-2492

Phone

(801) 892-4001

NPI assigned

Feb 17, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1171670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433376000000",
    "number": "1588708960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6616 S 900 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841212492",
            "telephone_number": "801-892-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6616 S 900 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841212492",
            "telephone_number": "801-892-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "WALTER",
        "middle_name": "E.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-17",
        "last_updated": "2015-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZC0006X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology",
            "state": "UT",
            "license": "9347417-1204",
            "primary": true
        },
        {
            "code": "207ZC0006X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology",
            "state": "NV",
            "license": "DO1987",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charlotte Kelley
• Karen R Kelley, MD
• Kristen Kelley, MD
• Linda Kelley
• Todd William Kelley, M.D.
• Kelly D. Carroll D.D.S., PC
• Christina Kelly Lecluyse, LCSW
• Brenna Grace Kelly, MD
• Brian M Kelly, APRN, FNP
• Carol Sue Kelly

• Clinical Pathology Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Clinical Pathology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2015; 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.