Individual provider Active NPI

Patrick Sean Kelly, MD

  • Internal Medicine Physician
  • Murray, KY
National Provider Identifier
1598747396
Registry record updated Aug 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
32195 Issued in KY
Practice address
803 Poplar St
Murray, KY 42071-2432
Phone
(270) 762-1100
NPI assigned
Nov 17, 2005
Last updated
Aug 2, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 32195 KY Primary

Addresses

Primary practice location

803 Poplar St
Murray, KY 42071-2432

Mailing address

1000 S 12TH St
Murray, KY 42071-9303
Phone (270) 759-9200

Other practice location 1

1000 S 12th St
Murray, KY 42071-9303
Phone (270) 759-9200

Other identifiers 3

IdentifierTypeStateIssuer
000000050312OtherKYANTHEM PROVIDER NUMBER
64321953MedicaidKY
110168896OtherKYRAILROAD MEDICARE PROV NO

Other names 1

  • P Sean Kelly Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20101027001499 KY Practitioner - Internal Medicine 8426147414 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Louisville School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

803 Poplar St
Murray, KY 42071-2432
Phone (270) 762-1597

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
32195KYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
VMD Primary Providers Central Kentucky Internal Medicine CurrentSince Jan 1, 2020 Accepting new patients
Murray-Calloway County Public Hospital Corporation CurrentSince Aug 1, 2022 Accepting new patients
Murray-Calloway County Public Hospital Corporation Internal Medicine CurrentSince Aug 1, 2022 Accepting new patients
Murray-Calloway County Public Hospital Corporation Internal Medicine Current Accepting new patients
VMD Primary Providers Central Kentucky Internal Medicine CurrentSince Jan 1, 2020 Accepting new patients
Murray-Calloway County Public Hospital Corporation Past Accepting new patients

Locations

543 Powell Ln
Benton, KY 42025
Phone (270) 252-1700

1000 S 12th St
Murray, KY 42071
Phone (270) 759-9200

300 S 8th St
Ste 380W
Murray, KY 42071
Phone (270) 753-0704

300 S 8th St
Ste 480W
Murray, KY 42071
Phone (270) 762-1104

803 Poplar St
Murray, KY 42071
Phone (270) 762-1155

Organizations & group practices 6

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1598747396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 S 12TH ST",
            "city": "MURRAY",
            "state": "KY",
            "postal_code": "420719303",
            "telephone_number": "270-759-9200",
            "fax_number": "270-759-9966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 POPLAR ST",
            "city": "MURRAY",
            "state": "KY",
            "postal_code": "420712432",
            "telephone_number": "270-762-1100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 S 12th St",
            "address_purpose": "LOCATION",
            "city": "Murray",
            "state": "KY",
            "postal_code": "420719303",
            "country_code": "US",
            "telephone_number": "270-759-9200",
            "fax_number": "270-759-9966",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "PATRICK",
        "middle_name": "SEAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-17",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "32195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "000000050312",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64321953",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PROV NO",
            "identifier": "110168896",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "P",
            "last_name": "KELLY",
            "middle_name": "SEAN",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Murray, KY

Sources for this page

Verify at the official NPI Registry.