John J Kelly, MD

Primary specialty

Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X

License

25987 Issued in AZ

Practice address

579 W Moorwood St
Green Valley, AZ 85614-5980

Phone

(414) 737-9122

NPI assigned

Apr 5, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1554422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554422400000",
    "number": "1629530712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "579 W MOORWOOD ST",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "856145980",
            "telephone_number": "414-737-9122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "579 W MOORWOOD ST",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "856145980",
            "telephone_number": "414-737-9122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JOHN",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-05",
        "last_updated": "2019-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0602X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": "AZ",
            "license": "25987",
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "AZ",
            "license": "25987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth H. Jordan, WHNP
• Marnie Lee Joseph
• Julia F. Granone, DPM, PC
• Cheyann Marie Kanavel, LMT
• William Francis Kazantzis, PHARMD
• Stephanie Lynn Kelly, NP-C
• Ruth Catherine Kenrick, M.A., L.I. C.S.W.
• Kent H. Wyatt, D.D.S., P.C.
• Rossa Khalaf, MD
• Matthew Khumalo, MD

• Otolaryngology/Facial Plastic Surgery Physician in Green Valley, AZ
• Providers in Green Valley, AZ by specialty
• Otolaryngology/Facial Plastic Surgery Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2019; 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.