Abigail Kelly, MD

Primary specialty

Military Health Care ProviderTaxonomy code 171000000X

Practice address

9040 Jackson Ave
Tacoma, WA 98431-0001

Phone

(253) 968-3105

NPI assigned

Feb 28, 2022

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: akelly3864196@wm.providencedirect.org

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 3, 2023.

{
    "created_epoch": "1646006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691020800000",
    "number": "1639825664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001",
            "telephone_number": "253-968-3105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001",
            "telephone_number": "253-968-3105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "ABIGAIL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-28",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erik Daniel Kellison, PHARMD
• John Patrick Kellogg, D.C.
• Will Kellogg, MD
• Kelly a Blasko PHD LLC
• Denise Kelly-Ballweber, CCC
• Brittany Aimee Kelly, MSW, LCSW
• Dennis Allan Kelly, PH.D.
• Heidi Ann Kelly
• Ian Patrick Kelly, MD
• Jessica Kelly, MSW, LMSW

• All providers in Tacoma, WA
• Military Health Care Provider in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 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.