NPIMap

Organization Active NPI

David B. Kelley, M.D., Inc., P.S.

  • Primary Care Clinic/Center
  • Olympia, WA
National Provider Identifier
1629308564
Registry record updated Dec 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
MD00016317 Issued in WA
Legal business name
DAVID B. KELLEY, M.D., INC., P.S.
Practice address
408 Lilly Rd NE Ste C
Olympia, WA 98506-6954
Phone
(360) 456-5545
Fax
(360) 456-5854
NPI assigned
Dec 27, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2009

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

Authorized official

Name
Dr. David B Kelley, M.D.
Title
President & Ceo
Phone
(360) 456-5545

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X MD00016317 WA Primary

Addresses

Primary practice location

408 Lilly Rd NE Ste C
Olympia, WA 98506-6954

Mailing address

408 Lilly Rd NE Ste C
Olympia, WA 98506-6954
Phone (360) 456-5545

National Provider Directory

National Provider Directory

Locations

408 Lilly Rd NE
Ste C
Olympia, WA 98506
Phone (360) 456-5545

NPI Registry JSON

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

{
    "created_epoch": "1261872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261872000000",
    "number": "1629308564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 LILLY RD NE STE C",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985066954",
            "telephone_number": "360-456-5545",
            "fax_number": "360-456-5854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 LILLY RD NE STE C",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985066954",
            "telephone_number": "360-456-5545",
            "fax_number": "360-456-5854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID B. KELLEY, M.D., INC., P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-27",
        "last_updated": "2009-12-27",
        "status": "A",
        "authorized_official_last_name": "KELLEY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "360-456-5545",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "WA",
            "license": "MD00016317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2009; 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.