Jason Lee Kelly, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

33261 Issued in AL

Practice address

9000 Bailey Cove Rd SE
Huntsville, AL 35802-4002

Phone

(256) 428-4900

Fax

(256) 428-4912

NPI assigned

Jun 17, 2011

Last updated

Aug 31, 2021By 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AL

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

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/7105/brand/1/csg/1/fhir/r4

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.

• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  AL

  Medicare reassignment NPD
• Centre Clinic Corp

  • Family Medicine Physician
  • Centre, AL
  • NPI 1558315689
  NPD (past)

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

{
    "created_epoch": "1308268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1598050544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2705",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358042705",
            "telephone_number": "256-801-6048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 BAILEY COVE RD SE",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358024002",
            "telephone_number": "256-428-4900",
            "fax_number": "256-428-4912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JASON",
        "middle_name": "LEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-17",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "33261",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "193074",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Psychiatric Services, LLC
• Kelly S Fisher LLC
• Carmalita Kelly, CRNP
• Frank J. Kelly II, MD
• James Tracy Kelly, OTR
• Kendra Kelly
• Lauren Kelly, CRNP
• Mallory Morris Kendall, CRNP
• Angenique Mychele Kendricks
• Christel McGee Kennedy, CRNP

• Family Medicine Physician in Huntsville, AL
• Providers in Huntsville, AL by specialty
• Family Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; 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.