Gregory Dennis Kelly, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

744 Issued in WV

Practice address

1400 Hospital Dr
Emergency Department
Hurricane, WV 25526-9202

Phone

(304) 757-1767

Fax

(304) 757-1716

NPI assigned

Nov 7, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Charleston Area Medical Center Inc

  • General Acute Care Hospital
  • Charleston, WV
  • NPI 1952390239
  NPD (past)
• New Century Emergency Physician of West Virginia Inc

  • Emergency Medicine Physician
  • Charleston, WV
  • NPI 1396722641
  NPD (past)

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484006400000",
    "number": "1609945443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 HOSPITAL DR",
            "city": "HURRICANE",
            "state": "WV",
            "postal_code": "255269202",
            "telephone_number": "800-875-0136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 HOSPITAL DR",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "HURRICANE",
            "state": "WV",
            "postal_code": "255269202",
            "telephone_number": "304-757-1767",
            "fax_number": "304-757-1716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "GREGORY",
        "middle_name": "DENNIS",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2017-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WV",
            "license": "744",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000681385",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WV DWC",
            "identifier": "1052927",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WV MEDICAID",
            "identifier": "0050063000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shawna Jones, APRN,PMHNP-BC
• Sonya Marie Jones
• Kanawha Valley Neurology
• Jessica Lynn Keathley, PTA
• Kirstin Keeney
• Jodi Kelly, P.T.
• Kerry Lee Kendrick, DDS
• Kerry Kendrick, DDS, PLLC
• Stephanie Nicole Kessell, RN
• Kidney Associates PLLC

• Emergency Medicine Physician in Hurricane, WV
• Providers in Hurricane, WV by specialty
• Emergency Medicine Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2017; 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.