Individual provider Active NPI

Kelly Jo Ely, RN

  • Cardiovascular Disease Physician
  • Richmond, VA
National Provider Identifier
1619650108
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
0001292795 Issued in VA
Practice address
7101 Jahnke Rd
Richmond, VA 23225-4017
Phone
(804) 483-2380
Fax
(804) 483-2381
NPI assigned
Aug 10, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 0001292795 VA Primary

Addresses

Primary practice location

7101 Jahnke Rd
Richmond, VA 23225-4017

Mailing address

17343 Burchett LN
Beaverdam, VA 23015-1779
Phone (804) 878-4651

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
0001292795VAMDCardiovascular Disease Physician

NPI Registry JSON

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

{
    "created_epoch": "1691625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1619650108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17343 BURCHETT LN",
            "city": "BEAVERDAM",
            "state": "VA",
            "postal_code": "230151779",
            "telephone_number": "804-878-4651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7101 JAHNKE RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232254017",
            "telephone_number": "804-483-2380",
            "fax_number": "804-483-2381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELY",
        "first_name": "KELLY",
        "middle_name": "JO",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-10",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "VA",
            "license": "0001292795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2023; 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.